Purtscher retinopathy after head trauma

Abstract

Purtscher retinopathy is an acute retinal microangiopathy mainly associated with severe trauma, characterized by occlusion of the retinal microvasculature leading to retinal edema, hemorrhages, and whitish lesions with sudden decrease in visual acuity. Case presentation. We report the case of a male patient with a history of closed traumatic brain injury due to a fall from approximately six meters, initially evaluated at a high-complexity hospital and discharged without apparent neurological involvement, who developed abrupt bilateral visual loss 24 hours after the event. Fundoscopic examination revealed optic discs with poorly defined margins, multiple intraretinal hemorrhages, and hypopigmented lesions in both eyes, findings that allowed the diagnosis to be established when correlated with the traumatic history. Treatment. Treatment with systemic and topical corticosteroids was initiated, along with topical anti-inflammatory medication. Outcome. Close follow-up showed progressive resorption of retinal hemorrhages and improvement in visual acuity, demonstrating a favorable clinical course; however, there was no complete resolution at five months of follow-up, as the patient presented with irreversible macular atrophy as a sequela.