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Case Report
Bilateral Purtscher-like retinopathy associated to mixed connective tissue disease
1 University of Puerto Rico, School of Medicine, Ophthalmology Department, San Juan, Puerto Rico
2 Central University of the Caribbean, School of Medicine, Bayamon, Puerto Rico
3 University of Puerto Rico, School of Medicine, San Juan, Puerto Rico
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Mariam S Vila-Delgado
Ophthalmology Department, PO Box 365067, San Juan, PR 00936- 5067,
Puerto Rico
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Article ID: 100014Z17MP2019
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Vila-Delgado MS, Serrano L, Barquet V, Santiago A. Bilateral Purtscher-like retinopathy associated to mixed connective tissue disease. J Case Rep Images Opthalmol 2019;2:100014Z17MP2019.ABSTRACT
Introduction: Purtscher-like retinopathy (PuR) is a rare vaso-occlusive retinopathy that can be associated with an autoimmune inflammatory process. In this case report we describe the clinical presentation of a patient with bilateral PuR with previously undiagnosed mixed connective tissue disease (MCTD).
Case Report: A 64-year-old female with recently diagnosed hypertension, hypothyroidism, and osteoarthritis presented to our clinic complaining of blurred vision in both eyes of three weeks duration. At initial presentation, visual acuity was count fingers in both eyes. On dilated fundus exam the patient presented with bilateral peripapillary and macular hemorrhages associated to medium sized cotton-wool spots and Purtscher flecken along arcades limited to Zone 1. Review of systems revealed a self-limited episode of severe arm pain associated to bluish discoloration of the overlying skin six months prior, followed by progressive digit necrosis in upper and lower extremities. Work up was consistent with a diagnosis of MCTD. The patient was treated with intravenous (IV) methylprednisolone and mycophenolate mofetil.
Conclusion: Diagnosis of bilateral PuR in the setting of MCTD is a rare presentation and warrants further study of potential screening in symptomatic patients as well as treatment regimen upon PuR diagnosis.
Keywords: Mixed connective tissue disease, Purtscher, Retinopathy
SUPPORTING INFORMATION
Author Contributions
Mariam S Vila-Delgado - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Luis Serrano - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Viviana Barquet - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Alejandra Santiago - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Mariam S. Vila-Delgado et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
