Purtscher-like retinopathy as a complication of acute pancreatitis

Česká verze

Authors: L. Rišková ^1,2; L. Korec ²; M. Alexík ³; E. Huľo ⁴; S. Huľová ⁴
Authors place of work: Chirurgická klinika a transplantačné centrum UNM a Jesseniova lekárska fakulta v Martine Univerzita Komenského v Bratislave prednosta: prof. MUDr. Ľ. Laca, PhD. ¹; Chirurgické oddelenie NsP Považská Bystrica primár: MUDr. L. Korec ²; Oftalmologické oddelenie FNsP Žilina primár: MUDr. M. Štubňa, PhD. ³; Chirurgické oddelenie NsP Levoča primár: MUDr. E. Huľo, PhD. ⁴
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 12, s. 449-452.
Category: Kazuistika

Summary

Introduction:
Purtscher-like retinopathy as a complication of acute pancreatitis is a disease which causes generalized retinal and macular oedema associated with retinal surface haemorrhage, which results in a permanent, sometimes partially reversible visual loss.

Case report:
The case report presented in this article refers to the case of a 36-year-old woman with severe acute pancreatitis. The pancreatitis led to the development of acute respiratory insufficiency with signs of septic shock and consequently, the patient was transferred to the critical care unit. The patient underwent a total of 8 surgical interventions with the revision of the abdominal cavity, necrectomy and application of the vacuum system into the abdominal cavity. Eye exams were conducted for impaired vision with the conclusion of Purtscher-like retinopathy associated with acute pancreatitis, occlusion of the central retinal artery of both eyes, confirmed by fluorescence angiography. After one year, alterations of the retina show no signs of improvement in this case; the loss of vision is permanent.

Key words:
acute pancreatitis −⁠ Purtscher-like retinopathy

Zdroje

1. Purtscher O. Noch unbekannte befunde nach schadeltrauma. Ber Zusammenkunft Dtsch Ophthalmol Ges Journal 1910;36 : 294−301.

2. Tabandeh H, Rosenfeld PJ, Alexandrakis G, et al. Purtscher-like retinopathy associated with pancreatic adenocarcinoma. Am J Ophthalmol 1999;128 : 650−2.

3. Inkeles DM, Walsh JB. Retinal fat amboli as sequela to acute pancreatitis. Am J Ophthalmol 1975;80 : 935-8.

4. Kincaid MC, Green WR, Knox DL, et al. A clinicopathological case report of retinopathy of pancreatitis. Br J Ophthalmol 1982;66 : 219−26.

5. Harrison TJ, Abbasi CO, Khraishi TA. Purtscher retinopathy: an alternative etiology supported by computer fluid dynamic simulations. Invest Ophthalmol Vis Sci 2011;528102−7.

6. Krahulec B, Stefaničková J, Hlinst‘áková S, et al. Purtscher-like retinopathy –⁠ a rare complication of acute pancreatitis. Vnitr Lek 2008;54 : 276−81.

7. Agrawal A, McKibbin M. Purtscher´s retinopathy: epidemiology, clinical features and outcome. Br J Ophthalmol 2007;91 : 1456−9.

8. Atabay C, Kansu T, Nrlu G, Late visual recovery after intravenous methylprednisone treatment of Purtscher´s retinopathy. Annals of Ophalmology 1993;25 : 330−3.