Ischemic central retinal venous occlusion as a possible differential diagnosis of Purtscher-like retinopathy

Tripathy, K.

doi:10.1016/j.oftale.2019.05.013

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(b) The tumoration is composed of an epithelial basaloid cells proliferation which forms nests infiltrating a markedly desmoplastic stroma (HE 100×)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N. Ibáñez-Flores, C. Bruzual-Lezama, J.J. Castellar-Cerpa, L. Fernández-Montalvo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Ibáñez-Flores" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Bruzual-Lezama" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Castellar-Cerpa" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Fernández-Montalvo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119301285" "doi" => "10.1016/j.oftal.2019.04.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119301285?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301021?idApp=UINPBA00004N" "url" => "/21735794/0000009400000010/v1_201910010751/S2173579419301021/v1_201910010751/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Ischemic central retinal venous occlusion as a possible differential diagnosis of Purtscher-like retinopathy" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "518" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "K. Tripathy" "autores" => array:1 [ 0 => array:4 [ "nombre" => "K." "apellidos" => "Tripathy" "email" => array:1 [ 0 => "koushiktripathy@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Vitreoretina and Uvea, ASG Eye Hospital, Kolkata, West Bengal, India" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oclusión venosa central de la retina isquémica como posible diagnóstico diferencial de la retinopatía tipo Purtscher" ] ] "textoCompleto" => "I read with interest the case report by Espinosa-Barberi G and colleagues,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> which discusses the management of a patient with macular edema in one eye with intravitreal dexamethasone implant, intravitreal aflibercept, and repeat intravitreal dexamethasone implant. This eye had ‘established papillary edema with peripapillary flame hemorrhages and other deep hemorrhages in the 4 quadrants, as well as vascular tortuosity, featuring peripapillary cotton-like spots and macular edema’<a class="elsevierStyleCrossRef" href="#bib0005">1</a> and a diagnosis of unilateral Purtscher-like retinopathy was made.A suggested diagnostic criteria<a class="elsevierStyleCrossRef" href="#bib0010">2</a> of Purtscher’s or Purtscher-like retinopathy (PuR) needed at least 3 of the following 5 features-<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">1Purtscher flecken</li><li class="elsevierStyleListItem" id="lsti0010">2Retinal hemorrhages, low-to-moderate number (1–10)</li><li class="elsevierStyleListItem" id="lsti0015">3Cotton-wool spots (typically restricted to posterior pole)</li><li class="elsevierStyleListItem" id="lsti0020">4Probable or plausible explanatory etiology</li><li class="elsevierStyleListItem" id="lsti0025">5Complementary investigation compatible with diagnosis</li></ul>Purtscher flecken is a polygonal area of retinal whitening with typical paravascular clear areas which is not present in the discussed case.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> The reported patient<a class="elsevierStyleCrossRef" href="#bib0005">1</a> has 2 features (retinal hemorrhages, and cotton wool spot) but other 3 features are not met. Typically, intraretinal hemorrhage in PuR is less severe and retinal whitening with or without cotton-wool spots predominate the fundus finding. Also, the systemic diseases of the patient including diabetes mellitus, hypertension, and hypercholesterolemia alone have not been reported to cause PuR, to the best of my knowledge.On the other hand, the patient<a class="elsevierStyleCrossRef" href="#bib0005">1</a> had dilated tortuous retinal vessels, peripheral retinal hemorrhages, disc edema, macular edema, retinal hemorrhages, peripapillary cotton wool spots, extensive capillary nonperfusion on fluorescein angiography, poor vision, and relative afferent pupillary defect. All these findings may be explained by ischemic or nonperfused central retinal venous occlusion (CRVO).<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Thus in the presented case,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> a differential diagnosis of ischemic CRVO may be kept, though typically there are more areas of retinal hemorrhage in such cases. Uncontrolled hypertension may have added to the prominence of cotton-wool spot and severe macular edema." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Tripathy K. Oclusión venosa central de la retina isquémica como posible diagnóstico diferencial de la retinopatía tipo Purtscher. Arch Soc Esp Oftalmol. 2019. https://doi.org/10.1016/j.oftal.2019.05.018" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio multimodal y tratamiento de la retinopatía tipo Purtscher" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Espinosa-Barberi" 1 => "C. Alba Linero" 2 => "V. Llorens Bellés" 3 => "A. Adán Civera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2019" "volumen" => "94" "paginaInicial" => "45" "paginaFinal" => "49" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic review of Purtscher’s and Purtscher-like retinopathies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.I.M. Miguel" 1 => "F. Henriques" 2 => "L.F.R. Azevedo" 3 => "A.J.R. Loureiro" 4 => "DaL. Maberley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eye Lond Engl" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "1" "paginaFinal" => "13" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fundus changes in central retinal vein occlusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.S. Hayreh" 1 => "M.B. Zimmerman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Retina Phila Pa" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "29" "paginaFinal" => "42" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009400000010/v1_201910010751/S2173579419301379/v1_201910010751/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009400000010/v1_201910010751/S2173579419301379/v1_201910010751/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301379?idApp=UINPBA00004N"]

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Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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Vol. 94. Issue 10.

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