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      Purtscher-like retinopathy associated with acute pancreatitis Translated title: Retinopatia de Purtscher associada com pancreatite aguda

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          Abstract

          CONTEXT: Purtscher-like retinopathy with bilateral loss of vision is a rare and severe complication that may follow acute pancreatitis. CASE REPORT: The case of a 35-year-old patient with acute alcoholic pancreatitis who developed sudden loss of visual acuity is described. The ophthalmoscopic examination revealed diffuse retinal whitening of the posterior pole with confluent cotton-wool spots. Fluorescein angiogram showed retinal arteriolar occlusion. The findings were compatible with Purtscher-like retinopathy. Computed tomography of the abdomen demonstrated enlarged liver and pancreas with edema and inflammation. The pathogenesis of this form of retinopathy still remains uncertain and there is no specific treatment available.

          Translated abstract

          CONTEXTO: Retinopatia de Purtscher com redução da visão bilateral é uma rara e grave complicação da pancreatite aguda. RELATO DE CASO: O caso de um paciente de 35 anos com pancreatite alcoólica aguda que apresentou diminuição súbita da acuidade visual é descrito. Oftalmoscopia revelou pólo posterior esbranquiçado devido à presença de manchas algodonosas confluentes. Angiografia fluoresceínica mostrou oclusão arteriolar retiniana. Os achados eram compatíveis com retinopatia de Purtscher. Tomografia computadorizada do abdômen demonstrou fígado e pâncreas aumentados, com edema e inflamação. A patogênese desta forma de retinopatia ainda é incerta e não há tratamento específico disponível.

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          A clinicopathological case report of retinopathy of pancreatitis.

          A 32-year-old black woman with pancreatitis developed visual loss in both eyes. On ophthalmoscopic examination she had extensive ischaemic infarcts at the posterior poles of both eyes, a clinical picture which has been reported previously in patients with pancreatitis and noted to be similar to Purtscher's retinopathy. On histopathological examination of the eyes after death there were arteriolar occlusions in both the choroid and retina and inner ischaemic infarctions with inner retinal oedema. Owing to the 23-day interval from arteriolar occlusion until death the exact nature of the original occlusion could not be determined. However, either fat emboli or activated complement C5-induced granulocyte embolus formation are possible causes.
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            Purtscher-like retinopathy associated with pancreatic adenocarcinoma.

            To investigate a case of Purtscher-like retinopathy that occurred in association with pancreatic adenocarcinoma. Case report. A 63-year-old woman presented with multiple gray patches in the central vision of both eyes. Visual acuity was 20/20 in both eyes. Funduscopy showed large peripapillary yellow-white patches within the superficial retina and small superficial retinal hemorrhages in both eyes. The patient subsequently had abdominal pain. Computed tomography of the abdomen demonstrated a large pancreatic mass with extension into the liver. Histologic examination of a percutaneous needle biopsy specimen showed mucinous pancreatic adenocarcinoma. Pancreatic adenocarcinoma should be added to the list of systemic diseases that can be associated with Purtscher-like retinopathy.
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              Retinal Fat Emboli as A Sequela to Acute Pancreatitis

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                Author and article information

                Journal
                spmj
                Sao Paulo Medical Journal
                Sao Paulo Med. J.
                Associação Paulista de Medicina - APM (São Paulo, SP, Brazil )
                1516-3180
                1806-9460
                December 2005
                : 123
                : 6
                : 289-291
                Affiliations
                [01] Campinas São Paulo orgnameUniversidade Estadual de Campinas orgdiv1Department of Ophthalmology Brazil
                Article
                S1516-31802005000600008 S1516-3180(05)12300608
                10.1590/S1516-31802005000600008
                16444390
                f87a999f-1ed6-4067-b9c1-a8abd42b5a63

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 September 2005
                : 01 June 2004
                : 30 September 2005
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 5, Pages: 3
                Product

                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Case report

                Pancreatite,Vision disorders,Pancreatitis,Case reports,Visual acuity,Retina,Acuidade visual,Transtornos da visão,Relatos de casos

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