Journal Article

Sudden loss of vision: Purtscher retinopathy in multiple myeloma

Hong, Feiyu, Nautiyal, Amit, Doft, Bernard, Gradowski, Joel F., Jameson, Angus, Amescua, Guillermo

2009

Overview

A 53-year-old man presented with acute, severe loss of vision in both eyes. Three days earlier, he had noticed a painless deterioration of his vision, which had progressed until he could no longer read a newspaper using either eye. On examination, the patient's best corrected visual acuity was 20/100 using both eyes. He had full visual fields by confrontation and the motility of extraocular muscles was normal. No afferent pupillary defect was evident. Examination of the posterior segment showed bilateral edema in the optic nerve head with multiple cotton wool spots and areas of retinal whitening (Purtscher flecken) (Figure 1). Intravenous fluroescein angiography showed severe ischemia of the nasal macular retinal arterioles with extensive secondary late leakage. Based on these findings, we diagnosed [M. Purtscher] disease or Purtscher-like angiopathic retinopathy.

• Publisher: Elsevier Inc,CMA Impact Inc,CMA Joule Inc,CMA Impact, Inc,Canadian Medical Association
• Subject: Blindness - diagnosis / Blindness - etiology / Care and treatment / Case studies / Complications and side effects / Diagnosis / Eye diseases / Fluorescein Angiography / Humans / Low vision / Male / Medical diagnosis / Middle Aged / Multiple myeloma / Multiple Myeloma - complications / Practice / Retinal diseases / Retinal Diseases - diagnosis / Retinal Diseases - etiology / Risk factors