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CONTRALATERAL VISION LOSS AFTER ENDONASAL DACRYOCYSTORHINOSTOMY

A CASE REPORT OF PURTSCHER-LIKE RETINOPATHY AND TREATMENT WITH INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR

Gungel, Hulya, MD*; Altan, Cigdem, MD; Karini, Belma, MD*; Ozdemir, Fatma E., MD*; Celebi, Ozlem O., MD

Retinal Cases and Brief Reports: July 2019 - Volume 13 - Issue 3 - p 255–259
doi: 10.1097/ICB.0000000000000574
Case Report
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Purpose: To present a case of a patient with contralateral vision loss as a result of Purtscher-like retinopathy after an endonasal dacryocystorhinostomy and treatment with intravitreal tissue plasminogen activator injection.

Methods and Results: A 51-year-old woman who underwent a left endonasal dacryocystorhinostomy was referred with a complaint of decreased vision 1 day after surgery in her right eye. At the initial examination, the visual acuity of her right eye was hand motion. The fundoscopic examination revealed a premacular hemorrhage, diffuse intraretinal hemorrhages, multiple peripapillary cotton wool patches, and Purtscher flecken. The patient received 50 μg/0.1 mL of intravitreal tissue plasminogen activator injection. One day after the injection, visual acuity improved to 3/20. On 1-month follow-up without medication, the visual acuity improved to 6/20, and normal visual evoked potential latencies and amplitudes were detected.

Conclusion: Purtscher- like retinopathy may occur as a complication of endonasal dacryocystorhinostomy. Intravitreal tissue plasminogen activator may help relieve the embolization that occurs in Purtscher-like retinopathy.

Endonasal dacryocystorhinostomy may cause Purtscher-like retinopathy. Intravitreal tissue plasminogen activator injection may be a promising strategy for treating this disease.

*Istanbul Training and Research Hospital, Eye Clinic, Istanbul, Turkey;

Beyoglu Eye Training and Research Hospital, Istanbul, Turkey; and

Istanbul Training and Research Hospital, Otolaryngology Clinic, Istanbul, Turkey.

Reprint requests: Cigdem Altan, MD, Hukukcular Sitesi, C4/18 4, Levent, Istanbul, 34330 Turkey; e-mail: cigdem_altan@yahoo.com

None of the authors has any financial/conflicting interests to disclose.

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

© 2019 by Ophthalmic Communications Society, Inc.