J Korean Ophthalmol Soc.  2021 Mar;62(3):408-413. 10.3341/jkos.2021.62.3.408.

Purtscher-like Retinopathy after Aortic Valve Replacement Surgery

• Lee SH
• Kim JT

• KMID: 2514258
• DOI: http://doi.org/10.3341/jkos.2021.62.3.408

Abstract

Purpose
We report a case of Purtscher-like retinopathy after aortic valve replacement surgery.
Case summary
A 52-year-old male with bacteremia suspicious of infectious endocarditis was referred to our department for ophthalmic examination. Inflammatory reaction was evident in both anterior chambers. Fundus examination revealed infiltrative lesions with a Roth spot, and the patient was diagnosed with chorioretinitis. After 3 days, aortic valve replacement surgery was performed in the cardiac surgery department using cardioplegic solutions. Ophthalmologic exams were repeated after the valve surgery. The Roth spot had disappeared and infiltrated, leaving a clear margin. An anterior chamber cell was not noted. However, there were newly developed peripapillary superficial cotton-wool spots and delayed hemorrhagic lesions. Based on the medical history and specific pathognomonic fundus findings, the patient was diagnosed with Purtscher-like retinopathy. Four months later, all characteristic funduscopic features of Purtscher-like retinopathy had disappeared, leaving a remaining retinal nerve fiber defect and central visual field defect without any ophthalmologic treatment.
Conclusions
Although rare, doctors should be aware of the possibility of Purtscher-like retinopathy after valve replacement surgery. Further studies are needed to understand the unknown pathophysiology of Purtscher-like retinopathy.

Keyword

Chorioretinitis, Purtscher-like retinopathy, Valve replacement surgery