Purtscher-like retinopathy in a patient with COVID-19 and disseminated intravascular coagulation

Effie Z Rahman; Pooja Shah; Jeremy E Ong; Morton Goldberg; Sally S Ong

doi:10.1016/j.ajoc.2021.101229

Purtscher-like retinopathy in a patient with COVID-19 and disseminated intravascular coagulation

Am J Ophthalmol Case Rep. 2021 Dec:24:101229. doi: 10.1016/j.ajoc.2021.101229. Epub 2021 Nov 11.

Authors

Effie Z Rahman¹, Pooja Shah¹, Jeremy E Ong², Morton Goldberg³, Sally S Ong^{1

3}

Affiliations

¹ Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
² Westmead Hospital, Sydney, NSW, Australia.
³ Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

Purpose: To describe a unique case of Purtscher-like retinopathy after a severe, complicated COVID-19 course which included development of disseminated intravascular coagulation (DIC).

Observations: A 58-year-old male developed blurry vision in the left eye one week after being discharged from the hospital for severe COVID-19 pneumonia and DIC. He had been intubated and ventilated for 5 days. Fundus examination revealed optic nerve hyperemia in the right eye, optic nerve pallor in the left eye, arteriolar attenuation, multiple cotton wool spots and ill-defined areas of retinal whitening in the posterior pole in both eyes. His exam findings were most consistent with Purtscher-like retinopathy in both eyes.

Conclusions and importance: While several cases of central retinal artery and vein occlusion have been described in COVID-19 patients thus far, there has not been any reported cases of Purtscher-like retinopathy. To the best of our knowledge, this is the first case of Purtscher-like retinopathy in a patient who developed DIC during a severe COVID-19 infection.

Keywords: COVID-19 retinopathy; Disseminated intravascular coagulation in COVID-19; Purtscher-like retinopathy.

Publication types

Case Reports