27 year old patient with a history of alcohol abuse after consumption of fat meal and wine following epigastric pain noticed sudden bilateral visual loss: right eye logMAR 0, 94, left eye logMAR 1, 22. Retinal examination revealed massive edema in the central part of the retina, multiple cotton wool spots in the posterior pole peripapillary and flame-shaped hemorrhages. On the OCT, there was edema most of all in the inner part of the retina, but also subretinal, hyperreflectivity in the nerve fibre layers corresponding to massive cotton wool spots. Fluorescein angiography in the early phases showed hypofluorescent ischemic areas of the retina subsequently leakage developed in the late phases. Immediately after antibiotic and spasmoanalgetic treatment of the pancreatitis visual acuity improved and 2 months after beginning of the therapy visual acuity is logMAR 0 bilateraly. We proposed that the most suspected cause of Purtscher-like retinopathy in this case is fat embolism.

Klinika Oftalmológie LFUK a FNsP Bratislava