Neovascularization in Purtscher's retinopathy

A Case Report of Purtscher-Like Retinopathy Secondary to Pneumocystis jirovecii Pneumonia in an Immunocompromised Patient

To the best of our knowledge, we present the first case of a young adult male, on long-term immunosuppressive therapy following a live-donor kidney transplant, with Purtscher-like retinopathy (PLR) secondary to Pneumocystis jirovecii pneumonia (PCP). The patient had presented to a routine medical follow-up and complained of a few weeks' history of dyspnoea and tachycardia after minimal exertion followed by acute bilateral blurring of vision. Unfortunately, the patient did not respond to a trial of corticosteroid treatment and subsequently became severely visually impaired. This case report expands the aetiological spectrum behind PLR and helps portray the disease process which, in some cases, leads to severe ischaemic sequelae.

Purtscher's retinopathy followed by neovascular glaucoma

We report the case of a 66-year-old Japanese man who developed neovascular glaucoma secondary to Purtscher's retinopathy following a head injury. The patient presented at our hospital with blurred vision and a visual field abnormality in his left eye 1 month after suffering from a head injury. Upon initial presentation, his best-corrected visual acuity on a decimal chart was 1.5 oculus dexter and 0.6 oculus sinister. The intraocular pressure (IOP) was 12 mmHg in both eyes. Fundus examination of the left eye revealed multiple white lesions in the posterior pole. Optical coherence tomography demonstrated retinal edema, particularly in the inner retina. On the basis of these findings, a diagnosis of Purtscher's retinopathy was made. One month after the initial examination, the visual acuity in the left eye deteriorated to 0.01 in decimal chart, and the IOP increased to 37 mmHg. Gonioscopy showed angle neovascularization. The patient received an intravitreal bevacizumab injection and panretinal photocoagulation. Subsequently, the IOP normalized and the angle neovascularization regressed.