Amniotic Fluid Embolism, Purtscher-Like Retinopathy

Synonyms

Purtscher’s like retinopathy

Definition

Purtscher’s retinopathy is an occlusive micro-vasculopathy which was first described in 1910 by Otmar Purtscher. The estimated incidence is 0.24 persons per million per year (Ashish and Martin 2006; Retina and Vitreous 2014–2015).

Etiology

Purtscher’s retinopathy generally occurs as a result of cranial trauma or thoracic compression. When the etiology is nontraumatic, it is referred to as Purtscher-like retinopathy. Common causes of Purtscher-like retinopathy include acute pancreatitis, renal failure, amniotic fluid emboli, and autoimmune disease (Ashish and Martin 2006).

It is hypothesized to be caused by complement activation which causes granulocyte aggregation and leukoembolism. This process in turn occludes small arterioles such as those found in the peripapillary retina.

Clinical Presentation

Fundoscopic findings include Purtscher flecken (which consists of multiple areas of retinal whitening in the superficial aspect of the inner...