A New OCT Finding in Purtscher-Like Retinopathy

The authors report a new spectral-domain optical coherence tomography (SD-OCT) appearance observed in two patients with Purtscher-like retinopathy. In this prospective case series of three eyes of two patients with Purtscher-like retinopathy, the patients were assessed with biomicroscopy, fluorescein angiography (FA), and SD-OCT. The last examinations of the patients were performed at 3 months and 12 months, respectively. Both patients presented with decreased visual acuity. Fundus examination revealed a whitish-appearing parafoveal retina and scattered cotton-wool spots in the posterior retina. FA showed hypofluorescent spots that correspond to the cotton-wool spots and retinal hemorrhages seen clinically. SD-OCT scan of cotton-wool spots showed focal hyperreflectivity in the nerve fiber and the ganglion cell layers. SD-OCT scan of the macula in both patients showed hyperreflective areas in the inner plexiform, inner nuclear, outer plexiform, and outer nuclear layers. Hyperreflective areas disappeared during follow-up of the patients. Retinal thinning was observed in these areas after resolution. These findings are in accordance with histopathological findings and support the microvascular embolization theory in pathophysiology of Purtscher-like retinopathy. [ Ophthalmic Surg Lasers Imaging Retina . 2018;49:64–69.]