Introduction Purtscher retinopathy is an occlusive microvasculopathy related to trauma. Patients present with blurry vision and/or paracentral scotomas along with retinal signs of ischemia. Paracentral acute middle maculopathy may be associated with Purtscher retinopathy and is an optical coherence tomography–based diagnosis consisting of hyperreflective, band-like lesions in the middle retina. Case Report A patient involved in a motor vehicle accident (struck by a car while riding a bicycle) was symptomatic for paracentral visual distortions in both eyes. Funduscopic examination exhibited mild intraretinal whitening and cotton wool spots in both eyes, and parafoveal inner nuclear layer hyperreflectivity was evident on optical coherence tomography in both eyes. These findings of retinal ischemia are due to Purtscher retinopathy and concurrent paracentral acute middle maculopathy. Conclusion Purtscher retinopathy and paracentral acute middle maculopathy are related to trauma or other systemic conditions and manifest with signs of retinal ischemia. Clinical manifestations and prognosis are variable depending on the initial presentation and injury. Although mainstay treatment for both conditions is to closely monitor, other postulated treatment options have been investigated.
Rego et al. (Thu,) studied this question.