Document Detail


Systematic review of Purtscher's and Purtscher-like retinopathies.
MedLine Citation:
PMID:  23174749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: (1) To describe the clinical characteristics of Purtscher and Purtscher-like retinopathies, including etiologies, fundoscopic signs, results of complementary investigation, treatments, and outcomes. (2) To compare visual acuity (VA) of patients receiving corticosteroids for PuR compared with observation.
METHODS: Systematic review of several databases (1980-2010): Medline, EMBASE, ISI, EBSCO, Science Direct and Google Scholar. Study selection criteria included: (A) Studies of PuR with ophthalmology assessments; (B) ≥3 of 5 diagnostic criteria of PuR; (C) Quantified VA at presentation. For quantitative assessment (purpose 2), we selected only studies that reported whether corticosteroids were administered, and with vision assessments after at least 1 month.
RESULTS: (1) From 670 studies initially found, 40 were included (68 cases, 110 eyes): 1 prospective, 5 case series, and 34 case reports. Mean VA at presentation was 1.3 logMAR (logarithm of the minimum angle of resolution) (<20/200; range: 20/20-light perception). Purtscher flecken were underreported. Trauma and acute pancreatitis were the most frequent etiologies. There were six deaths, all with systemic associations. (2) There was no statistically significant difference between VA improvement for patients treated with corticosteroids compared with observation. Visual prognostic factors identified included etiology (pancreatitis and trauma were associated with higher probability of visual improvement) and male gender.
CONCLUSION: Due to limitations of case reports and series, the presented data are only useful as broad characterizations of the clinical course of PuR. Further studies, possibly including trials to assess the effectiveness of corticosteroids use, and larger prospective cohort studies, are necessary, but may not be feasible to conduct.
Authors:
A I M Miguel; F Henriques; L F R Azevedo; A J R Loureiro; D A L Maberley
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-11-23
Journal Detail:
Title:  Eye (London, England)     Volume:  27     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-10     Completed Date:  2013-06-04     Revised Date:  2014-09-25    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-13     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Diagnostic Techniques, Ophthalmological
Humans
Retinal Diseases* / diagnosis,  pathology,  physiopathology,  therapy
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones
Comments/Corrections
Comment In:
Eye (Lond). 2014 Aug;28(8):1040   [PMID:  24788011 ]
Eye (Lond). 2014 Aug;28(8):1038-40   [PMID:  24788018 ]
Eye (Lond). 2013 Jun;27(6):783-5   [PMID:  23558212 ]
Eye (Lond). 2013 Jun;27(6):785   [PMID:  23558208 ]

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