Purtscher视网膜病变是一种罕见的血管病变,在有严重创伤和其他全身性疾病病史的患者中报道。诊断是基于临床,严重程度各不相同。一名41岁的绅士患有基础控制不佳的糖尿病和血脂异常,被转诊到眼科进行糖尿病性视网膜病变筛查。他否认视觉投诉。眼部检查显示相对传入瞳孔缺损为阴性,双侧视力为6/6。眼前段检查无异常。双眼(眼球子宫,OU)眼底显示粉红色的椎间盘,杯盘比为0.4,乳头周围呈火焰状出血。右眼(眼角膜,OD)还显示了沿视网膜1区和2区的超颞区拱廊的多个棉绒斑点,而左眼(oculussinister,OS)在视网膜1区的超颞区拱廊上显示出单个棉绒斑点。否则,没有可见的视网膜栓塞,点状出血,或者硬渗出物,黄斑正常.视网膜特征不是糖尿病性视网膜病变的特征。它模仿高血压视网膜病变,但病人血压正常.黄斑光学相干断层扫描上没有内部视网膜增厚和高反射率,排除了视网膜静脉阻塞。这促使我们引出更多的历史,该患者最近因心肌梗塞入院,接受了心肺复苏和胸部按压7分钟。因此,诊断为OUPurtscher的视网膜病变,病人在诊所受到密切监测。Purtscher的视网膜病变仍然是一个诊断难题,在复杂的临床背景下不应被忽视。
Purtscher\'s retinopathy is a rare angiopathy reported in patients with a history of severe trauma and other systemic diseases. The diagnosis is made on clinical grounds, and the severity varies. A 41-year-old gentleman with underlying poorly controlled diabetes mellitus and dyslipidemia was referred to the ophthalmology department for diabetic retinopathy screening. He denied visual complaints. Ocular examination revealed a negative relative afferent pupillary defect with a visual acuity of 6/6 bilaterally. The anterior segment examination was unremarkable. Both eye (oculus uterque, OU) fundus revealed a pink disc with a cup-to-disc ratio of 0.4 and peripapillary flame-shaped hemorrhages. Right eye (oculus dexter, OD) also showed multiple cotton wool spots along the superotemporal arcade involving zones 1 and 2 of the retina, while left eye (oculus sinister, OS) showed a single cotton wool spot along the superotemporal arcade at zone 1 of the retina. Otherwise, there were no visible retinal emboli, dot hemorrhages, or hard exudates, and the macula was normal. The retinal features were not characteristic of diabetic retinopathy. It mimicked hypertensive retinopathy, but the patient was normotensive. The absence of inner retinal thickening and hyperreflectivity on optical coherence tomography of the macula ruled out retinal vein occlusion. This prompted us to elicit further history, and the patient disclosed a recent admission for myocardial infarction in which he received cardiopulmonary resuscitation with chest compressions for seven minutes. Hence, the diagnosis of OU Purtscher\'s retinopathy was made, and the patient was monitored closely in the clinic. Purtscher\'s retinopathy remains a diagnostic dilemma and should not be neglected in complex clinical contexts.