Tomasi L G, Rosman N P
Am J Dis Child. 1975 Nov;129(11):1335-7. doi: 10.1001/archpedi.1975.02120480051012.
Purtscher retinopathy is a hemorrhagic angiopathy that occurs after sudden compression of the thorax. Virtually all reported cases have been in adults who have decreased visual acuity, retinal hemorrhages and exudates, and no other neurological signs. By contrast, in infants, hemorrhagic retinopathy is rarely benign, and generally is considered to indicate intracranial hemorrhage, usually an acute subdural hematoma. Two battered infants had seizures and associated chest injury. There were retinal hemorrhages and exudates, unaccompanied by clinically important intracranial hemorrhage. At follow-up, the hemorrhagic retinopathy had resolved without sequelae; development was normal, and seizures had not recurred. Purtscher retinopathy thus should be added both to the differential diagnosis of hemorrhagic retinopathy in infancy and to the list of physical signs suggesting child abuse.
普尔夏视网膜病变是一种在胸部突然受压后发生的出血性血管病。几乎所有已报道的病例均见于成年人，这些患者视力下降、有视网膜出血和渗出物，且无其他神经体征。相比之下，在婴儿中，出血性视网膜病变很少是良性的，通常被认为提示颅内出血，通常是急性硬膜下血肿。两名受虐婴儿有癫痫发作并伴有胸部损伤。有视网膜出血和渗出物，但无具有临床意义的颅内出血。随访时，出血性视网膜病变已消退且无后遗症；发育正常，癫痫未再发作。因此，普尔夏视网膜病变应列入婴儿期出血性视网膜病变的鉴别诊断以及提示虐待儿童的体征清单中。
