SHM Converge Scientific Abstract ePoster Gallery-Acute Pancreatitis: An Eye-Opening Twist

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A 23-year-old man with alcohol use disorder was admitted with alcohol-induced interstitial edematous pancreatitis. Initial labs showed elevated lipase and lactic acidosis, and CT demonstrated steatohepatitis and acute pancreatitis without necrosis. About 24 hours after presentation, he developed sudden bilateral painless vision loss described as blurred and darkened vision. His vision did not improve after the pancreatitis resolved.<br /><br />He was diagnosed with Purtscher-like retinopathy, a rare but serious cause of vision loss associated with acute pancreatitis and trauma. The condition is typically bilateral and may present with fundoscopic findings such as Purtscher flecken, cotton-wool spots, and intraretinal hemorrhages. It is thought to result from emboli in precapillary arterioles causing retinal infarction, likely triggered in pancreatitis by complement activation and leukocyte aggregation.<br /><br />In this case, visual exam showed marked loss of near vision in the right eye and reduced acuity in the left, with fundus findings of diffuse macular whitening and Purtscher flecken in a peripapillary distribution in both eyes. There was a relative afferent pupillary defect in the right eye and visual field deficits.<br /><br />There is no proven treatment for Purtscher-like retinopathy, though corticosteroids have been reported to help in some cases. Importantly, this retinopathy is associated with multiple organ failure and poor prognosis in pancreatitis, so new vision changes in patients with acute pancreatitis should be monitored closely and evaluated promptly.

Asset Subtitle

Anthony H. Chen

Meta Tag

Author List Anthony H. Chen, Katherine I. Harris

Category Clinical Vignettes

Concept Purtscher-like retinopathy

Concept Acute Pancreatitis

Concept Purtscher flecken

Concept Painless vision loss

Concept Bilateral vision loss

Distinguished Non-Finalist

Presenter Organization Carver College of Medicine

Presenting Author Anthony H. Chen

Track Adult

Keywords

Purtscher-like retinopathy

acute pancreatitis

vision loss

bilateral blindness

Purtscher flecken

cotton-wool spots

retinal infarction

alcohol use disorder

fundoscopic findings

corticosteroids

Purtscher-like retinopathy

Acute Pancreatitis

Purtscher flecken

Painless vision loss

Bilateral vision loss