This is an acquired form of retinopathy associated
with a variety of thromboembolic events. It is the consequence of hemorrhagic and vasoocclusive vasculopathy.
Purtscher Angiopathic Retinopathy.
First described in 1910 by O. Purtscher as a syndrome of sudden
blindness associated with seveve head trauma. These patients presented with multiple white
retinal patches and retinal hemorrhages associated with seveve vision loss.
There is no reported incidence.
Variable depending on the underlying pathology. Acquired disease.
The clinical findings have traditionally been
associated with severe crush injuries. However, Purtscher retinopathy has
also been reported in association with pancreatitis, thrombocytopenic
purpura, hemolytic uremic syndrome, systemic lupus erythematosus,
dermatomyositis, scleroderma, and amniotic fluid embolism. The
ophthalmoscopic findings associated with this syndrome are peripapillary
cotton-wool spots, intraretinal hemorrhages, asymmetrical venous
engorgement, and retinal whitening. Obviously, the circumstances in which
Purtscher retinopathy develops determine the whole clinical picture.
The anesthetic management needs to take
into consideration the different causes of the underlying pathology. To
avoid sudden increases in intraocular pressure, medication susceptible to
affect it such as succinylcholine and ketamine should be avoided if
possible. Moderate hyperventilation can contribute to reduce intraocular
Power MH, Regillo CD, Custis PH: Thrombocytopenic purpura associated with
Purtscher's retinopathy. Arch Ophthalmol