# Purtscher's like retinopathy - A rare ocular complication of acute pancreatitis

## TL;DR

A rare eye condition called Purtscher's-like retinopathy can occur in patients with acute pancreatitis, highlighting the need for thorough medical evaluation.

## Contribution

This case report documents a rare ocular complication of acute pancreatitis and emphasizes the importance of ophthalmological assessment in such patients.

## Key findings

- Purtscher's-like retinopathy is a rare complication of acute pancreatitis with an incidence of less than 0.24 per million cases.
- The case highlights the importance of considering ophthalmological manifestations in patients diagnosed with acute pancreatitis.
- Prognosis and treatment for Purtscher's-like retinopathy remain variable and require further research.

## Abstract

Purtscher retinopathy is the rare form of occlusive microvasculopathy, characterized by multiple retinal white areas around the optic nerve head and fovea with paravascular clearing and may be related to intraretinal hemorrhages. Acute Pancreatitis (AP) is one of the most common gastrointestinal reasons for hospital admissions globally. The complications of Acute Pancreatitis may include Purtscher's-like retinopathy, which has a low incidence rate of less than 0.24 instances per million cases. This case report highlights the value of thorough medical history taking and examination, and it apprises the consideration of ophthalmological manifestation in patients of Acute Pancreatitis.

A 34-year-old female came to the emergency room due to intense abdominal pain associated with nausea and vomiting, which worsened over the last 24 h. The pain was described as continuous, sharp, and cramping-like in the upper abdomen, radiating to the back. Lab tests revealed elevated serum amylase and lipase levels, indicating pancreatitis, along with slight leukocytosis. A contrast-enhanced CT scan confirmed acute pancreatitis with mild inflammation and enlargement of the pancreas. Two days after admission, the patient experienced a sudden and painless loss of central vision in both eyes. There was no history of trauma or any other significant relevant history, other than pancreatitis. The ophthalmologist's examination found reduced visual acuity (6/60 in the right eye, 3/60 in the left eye), normal corneas, and anterior chambers.

Inkeles and Walsh established the first link between acute pancreatitis and Purtscher-like retinopathy when they reported three cases of the distinctive retinal appearance in individuals with acute pancreatitis in 1975.

The recovery and prognosis in cases of Purtscher-like retinopathy is variable and further research is required to ascertain the usage of corticosteroids and pentoxifylline in improving the course of a patient's with Purtscher's-like retinopathy.

•Purtscher retinopathy is the rare form of occlusive microvasculopathy•Complications of Acute Pancreatitis may include Purtscher's retinopathy, with low incidence of < 0.24 instances per million.•This case report highlights the value of thorough medical history taking and examination in patients of Acute Pancreatitis.•The recovery and prognosis in cases of Purtscher-like retinopathy is variable and further research is required.

Purtscher retinopathy is the rare form of occlusive microvasculopathy

Complications of Acute Pancreatitis may include Purtscher's retinopathy, with low incidence of < 0.24 instances per million.

This case report highlights the value of thorough medical history taking and examination in patients of Acute Pancreatitis.

The recovery and prognosis in cases of Purtscher-like retinopathy is variable and further research is required.