Retinopathy of pancreatitis indicates multiple-organ failure and poor prognosis in severe acute pancreatitis.

During hospitalization for severe acute necrotizing pancreatitis, a connection between the onset of retinopathy of pancreatitis and multiple-organ failure was studied. Ophthalmoscopy was repeated every second day and continuous staging for multiple-organ failure was performed in 38 patients. Typical retinopathy of pancreatitis developed in 7 of 10 patients with multiple-organ failure and only in 4 of the 28 patients without multiple-organ failure. Retinopathy of pancreatitis was observed in 7 of the 18 cases leading to lethal outcome and only in 4 of the 20 surviving patients. No correlation was observed between the development of retinopathy of pancreatitis and hemodialysis, pre-existing diabetes mellitus, abnormal platelet count, result of hemoculture, c reactive protein value, fraction of inspired oxygen and adult respiratory distress syndrome. In the 21 control patients in grave general state but without acute pancreatitis, retinopathy of pancreatitis was never observed. In our prospective study the onset of retinopathy of pancreatitis had clinical prognostic value and indicated multiple-organ failure and poor prognosis in severe acute necrotizing pancreatitis.