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Purtscher Retinopathy Treatment & Management

  • Author: Edward Chaum, MD, PhD; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Aug 04, 2015

Medical Care

No proven treatment exists for Purtscher retinopathy that occurs after traumatic injury.

In patients with retinopathy due to systemic vasculitis, steroid therapy is theoretically beneficial.

Control of the underlying disease with other medications may be indicated.


Surgical Care

Provide surgical care as required for traumatic chest and head injuries that are associated with Purtscher retinopathy.



Refer as indicated, based on the etiology of the retinopathy.



No restrictions are required, unless indicated by severe bilateral vision loss.

Contributor Information and Disclosures

Edward Chaum, MD, PhD Professor and Director, Vitreoretinal Service, Plough Foundation Professor of Retinal Diseases, Department of Ophthalmology, Professor of Pediatrics, Anatomy and Neurobiology, and Biomedical Engineering, University of Tennessee Health Science Center Hamilton Eye Institute

Edward Chaum, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, Association for Research in Vision and Ophthalmology, American Society of Retina Specialists, American Telemedicine Association, American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.

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Characteristic fundus findings of Purtscher retinopathy. Multiple cotton-wool spots surround the optic nerve after blunt thoracic trauma.
Mild Purtscher retinopathy in a patient after blunt chest compression as an unrestrained driver in a motor vehicle accident. This patient presented with visual loss in the left eye and had unilateral disease. The fundus photograph shows a large cotton-wool spot along the inferotemporal arcade and more subtle microvascular injury between the disc and fovea in the central macula. Whitening of the central fovea is present. Visual acuity was 20/200 but returned to 20/30 after 6 weeks.
Fluorescein angiogram of a patient who sustained blunt chest compression as an unrestrained driver in a motor vehicle accident shows focal microvascular occlusion in the area of the cotton-wool spot. Mild venous leakage and staining is seen in the perifoveal capillary bed just beneath the central fovea. A small amount of fluorescein leakage is also seen beneath the fovea.
Purtscher-like retinopathy in a patient with systemic lupus erythematosus with microvascular encephalopathy and retinopathy. Multiple cotton-wool spots of varying sizes and ages surround the optic nerve. A branch arterial occlusion is present along the supertemporal arcade with retinal whitening between the major artery and vein. Multiple occlusions are seen in arterial and venous trees with disruption of the blood columns.
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