Purtscher-like retinopathy following a bowel movement

To describe a case of Purtscher-like retinopathy that developed after a bowel movement. A 32-year-old male presented with blurry vision and bilateral temporal paracentral scotomas that developed immediately after standing up from a bowel movement. Fundoscopic examination was notable for bilateral co...

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Bibliographic Details
Published in:American journal of ophthalmology case reports 2022-06, Vol.26, p.101560, Article 101560
Main Authors: Sokol, Jared T., Castillejos, Alexandra, Sobrin, Lucia
Format: Article
Language:English
Subjects:
Bowel movement
Case Report
Purtscher's retinopathy
Purtscher-like retinopathy
Valsalva
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Summary:To describe a case of Purtscher-like retinopathy that developed after a bowel movement. A 32-year-old male presented with blurry vision and bilateral temporal paracentral scotomas that developed immediately after standing up from a bowel movement. Fundoscopic examination was notable for bilateral cotton wool spots in the nasal macula. Optical coherence tomography showed bilateral intraretinal fluid, subfoveal fluid, and scattered areas of inner retinal hyperreflectivity and thickening corresponding to the areas of cotton wool spots on examination. No treatment was administered and the patient had significant improvement in symptoms 2 days later with resolution of macular edema. Here we report a case of Purtscher-like retinopathy after a bowel movement. Although the exact mechanism of Purtscher-like retinopathy is unknown, there are multiple reports of Purtscher-like retinopathy after extreme events involving Valsalva, such as during weightlifting, and we postulate that this presentation is likely of similar pathophysiology.
ISSN:2451-9936
2451-9936
DOI:10.1016/j.ajoc.2022.101560