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.
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.
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: email@example.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.