COVID-19 associated with a Purtscher-like retinopathy
COVID-19 associated with a Purtscher-like retinopathy

COVID-19 associated with a Purtscher-like retinopathy

A patient in Italy experienced acute painless vision loss in both eyes and his visual acuity was reduced to counting fingers.

Marco Pastore, MD, from the Department of Ophthalmology, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy, worked with some colleagues to find out that retina and optic disc were linked to SARS-CoV-2 virus .

The researchers described the ophthalmoscopic examination showed “several polygonal areas of retinal bleaching at the posterior pole and around the optic disc associated with mild optic disc edema, nerve fiber layer infarcts and macular edema with pseudo-cherry red spot” in both eyes.

The results of optical coherence tomography (OCT) imaging showed “internal retinal hyperreflexivity, diffuse retinal thickening with intraretinal fluid and a serous macular detachment.”

The researchers diagnosed a paracentral acute intermediate maculopathy associated with capillary nonperfusion of the intermediate and deep capillary plexuses.

The patient underwent testing for SARS-CoV-2 virus and polymerase chain reaction confirmed the infection.

Laboratory experiments showed that both the levels of C-reactive protein and D-dimer were increased. The patient was negative for any infectious diseases. Pastore and his colleagues diagnosed Purtscher-like retinopathy associated with COVID-19. Treatment included intravenous methylprednisone (1,000 mg dose) for 7 days followed by oral corticosteroids.

Two months after the first presentation, vision improved from counting fingers to 20/32 and 20/25 in the right and left eyes, respectively. In addition, the authors reported that the detachment resolved with focal subfoveal ellipsoid zone disruption and reduced hyperreflexivity in the inner nuclear layer and the outer plexiform layer.


Pastore MR, Furlanis G, Tognetto D. Bilateral Purtscher-like retinopathy associated with SARS-CoV-2 infection. JAMA Ophthalmol 2022; 140 (2): e214979. doi: 10.1001 / jamaophthalmol.2021.4979

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