Functional and Anatomical Findings in Acute Purtscher’s Retinopathy

<i>Introduction:</i> To determine the anatomical location and functional impairment in acute Purtscher’s retinopathy (PR). <i>Material and Methods:</i> A 15-year-old boy with acute PR was examined with optical coherence tomography (OCT) and microperimetry (MP). <i>Results:</i> His initial best corrected visual acuity was 20/30 OD and 20/80 OS, the MP demonstrated absolute scotomas in the central and peripapillary area of the cotton-wool spots. On the OCT, there was a hyporeflective area in the inner aspect of the retina, corresponding to white patches on funduscopy. After he had been treated with oral prednisolone 100 mg, his visual acuity improved to 20/20 OU within 4 weeks and there were no scotomas on the MP. The central retinal architecture returned to normal with no sub- or intraretinal fluid. <i>Discussion:</i> Cotton-wool spots in PR represent infarctions of the retinal nerve fiber layer. Deeper layers of the retina may also be involved, causing a breakdown of the inner blood-retina barrier with temporary intra- and subretinal edema.