Subudhi Praveen, Kanungo Sanghamitra, Rao Subudhi Nageswar
Department of Ophthalmology, Ruby Eye Hospital, Berhampur, Odisha, India Department of Ophthalmology, KIMS, Bhubaneswar, Odisha, India.
Kar vision eye hospital, Bhubaneswar, Odisha, India Ruby Eye Hospital, Berhampur, Odisha, India.
BMJ Case Rep. 2016 Sep 14;2016:bcr2016215485. doi: 10.1136/bcr-2016-215485.
A 28-year-old man presented with a sudden onset of visual loss in both eyes (OU). He had a known history of acute pancreatitis and hepatitis following alcohol abuse. Examination of the anterior segment of the eye revealed non-sustained pupillary light reaction. The fundus showed typical Purtscher's flecken over the posterior pole with multiple cotton wool spots and retinal superficial haemorrhages in OU. Fundus fluorescein angiogram revealed abnormal hypofluorescence in both the posterior poles. Optical coherence tomography (OCT) for Purtscher's flecken showed abnormal retinal thickening with hyper-reflective areas in the inner neurosensory layers. The patient responded favourably to high-dose corticosteroid therapy (1.5 mg/kilogram per body weight) with a tapering dose. There was a mild reduction of the ischaemic areas with a corresponding improvement in visual acuity. This case has been presented owing to its rarity and under-reporting. Treatment with corticosteroids yielded favourable results.
一名28岁男性双眼突发视力丧失。他有酗酒导致急性胰腺炎和肝炎的病史。眼部前段检查显示瞳孔对光反应不持久。眼底检查发现双眼后极部有典型的普尔夏视网膜病变(Purtscher's flecken),伴有多个棉絮斑和视网膜浅层出血。眼底荧光血管造影显示双眼后极部有异常低荧光。针对普尔夏视网膜病变的光学相干断层扫描(OCT)显示视网膜内层神经感觉层有异常增厚及高反射区。患者对高剂量皮质类固醇治疗(1.5毫克/千克体重)反应良好,剂量逐渐减少。缺血区域轻度缩小,视力相应改善。由于该病例罕见且报告不足,故予以报道。皮质类固醇治疗取得了良好效果。