Pinto Christophe, Fernandes Tiago, Gouveia Petra, Sousa Keissy
Department of Ophthalmology, Hospital de Braga, Braga, Portugal.
Faculty of Medicine of Porto University, Porto, Portugal.
Am J Ophthalmol Case Rep. 2022 Jan 24;25:101301. doi: 10.1016/j.ajoc.2022.101301. eCollection 2022 Mar.
To report a case of Purtscher-like retinopathy treated with systemic steroids in a young woman with chronic kidney disease.
An 18-year-old female with a stage 3b chronic kidney disease presented with bilateral, sudden vision loss during an influenza-like syndrome. Best corrected visual acuity (BCVA) was 20/32 bilaterally and fundoscopic examination revealed cotton-wool spots, Purtscher flecken and intraretinal haemorrhages. Flourescein angiography showed areas of retinal ischemia with vascular leakage and optical coherence tomography showed cystoid macular oedema. The patient completed a short-course treatment with high-dose oral steroids. After 1 week, BCVA was 20/20 bilaterally. After 1 month, fundoscopy and imaging evaluation revealed complete resolution of the retinal injury. This favorable outcome remained stable throughout the 1-year follow-up.
AND IMPORTANCE: Purtscher-like retinopathy is a rare, sight-threatening retinal disorder. We described a case of retinal injury presumably related to chronic kidney disease and possibly triggered by an influenza-like syndrome, with a favorable visual recovery.
报告一例患有慢性肾脏病的年轻女性患者，其普尔夏样视网膜病变采用全身类固醇治疗的病例。
一名患有3b期慢性肾脏病的18岁女性，在出现类似流感综合征期间出现双侧突然视力丧失。最佳矫正视力（BCVA）双侧均为20/32，眼底检查发现棉絮斑、普尔夏斑和视网膜内出血。荧光素血管造影显示视网膜缺血区域伴有血管渗漏，光学相干断层扫描显示黄斑囊样水肿。患者完成了高剂量口服类固醇的短期治疗。1周后，BCVA双侧均为20/20。1个月后，眼底检查和影像学评估显示视网膜损伤完全消退。在1年的随访中，这一良好结果保持稳定。
普尔夏样视网膜病变是一种罕见的、威胁视力的视网膜疾病。我们描述了一例可能与慢性肾脏病相关且可能由类似流感综合征引发的视网膜损伤病例，该病例视力恢复良好。
