{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T15:33:34Z","timestamp":1757777614019,"version":"3.37.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Purtscher or Purtscher-like retinopathy is diagnosed by retinal hemorrhages and areas of retinal whitening on fundus examination, as well as a reduction in visual acuity due to microvascular occlusion of the precapillary retinal arterioles. We describe novel optical coherence tomography (OCT) findings of internal limiting membrane (ILM) separation and posterior hyperreflective dots in a case of Purtscher-like retinopathy in this report.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A 33-year-old man with acute pancreatitis and alcohol-induced liver disease presented to the retina department complaining of four days of painless vision loss in both eyes. Both eyes\u2019 anterior segment examination and intraocular pressure were normal. Dilated fundus examination of both eyes revealed confluent areas of retinal whitening, hemorrhages, and cotton-wool spots over the posterior pole, indicating Purtscher-like retinopathy. OCT scans through the macula revealed dense inner retinal reflectivity, thickening, and loss of retinal layer stratification, as well as outer retinal layer shadowing and islands of ILM separation, posterior vitreous hyperreflective dots, and minimal subfoveal fluid, all of which corresponded to areas of retinal whitening on fundus photographs. The patient was given a brief course of systemic steroids.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>On the tenth day after the presentation, visual acuity in the right eye had improved to 6\/18 and finger counting at 1\u00a0m in the left eye. The retinal findings had faded. The retina had reverted to its normal thickness on the OCT scans, with minimal hyperreflectivity remaining. The ILM separation and posterior vitreous hyperreflective dots were no longer present.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Following Purtscher or Purtscher-like retinopathy, we believe inflammation could play a major role in the development of these two novel OCT findings. This case offers an additional perspective on the underlying mechanisms responsible for the retinal manifestations observed in Purtscher or Purtscher-like retinopathy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12886-024-03413-w","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:02:12Z","timestamp":1711497732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Internal limiting membrane separation and posterior vitreous hyperreflective dots: novel OCT findings in Purtscher-like retinopathy"],"prefix":"10.1186","volume":"24","author":[{"given":"Vishma","family":"Prabhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aishwarya","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai Prashanti","family":"Chitturi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh Kumar","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Chhablani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-9390","authenticated-orcid":false,"given":"Ramesh","family":"Venkatesh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"3413_CR1","first-page":"294","volume":"36","author":"O Purtscher","year":"1910","unstructured":"Purtscher O. Noch Unbekannte Befunde Nach Schadeltrauma. Bericht Uber Die Zusammenkunft Der Deutschen Ophthalmologischen Gesellschaft. 1910;36:294\u2013301.","journal-title":"Bericht Uber Die Zusammenkunft Der Deutschen Ophthalmologischen Gesellschaft"},{"key":"3413_CR2","first-page":"421329","volume":"2015","author":"R Massa","year":"2015","unstructured":"Massa R, Vale C, Macedo M, Furtado MJ, Gomes M, Lume M, et al. Purtscher-like retinopathy. Case Rep Ophthalmol Med. 2015;2015:421329.","journal-title":"Case Rep Ophthalmol Med"},{"key":"3413_CR3","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.survophthal.2005.12.003","volume":"51","author":"A Agrawal","year":"2006","unstructured":"Agrawal A, McKibbin MA. Purtscher\u2019s and purtscher-like retinopathies: a review. Surv Ophthalmol. 2006;51:129\u201336.","journal-title":"Surv Ophthalmol"},{"key":"3413_CR4","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S0002-9394(14)72020-3","volume":"122","author":"F Gomez-Ulla","year":"1996","unstructured":"Gomez-Ulla F, Fente B, Torreiro MG, Salorio MS, Gonzalez F. Choroidal vascular abnormality in Purtscher\u2019s retinopathy shown by indocyanine green angiography. Am J Ophthalmol. 1996;122:261\u20133.","journal-title":"Am J Ophthalmol"},{"key":"3413_CR5","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/j.jfo.2019.11.014","volume":"43","author":"C Khodriss","year":"2020","unstructured":"Khodriss C, Chraibi F, Zarriq S, Bennis A, Abdellaoui M, Benatiya AI. [Choroidal ischemia during Purtscher\u2019s retinopathy]. J Fr Ophtalmol. 2020;43:668\u201370.","journal-title":"J Fr Ophtalmol"},{"key":"3413_CR6","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1097\/ICB.0b013e3181d42706","volume":"5","author":"A Giani","year":"2011","unstructured":"Giani A, Deiro AP, Sabella P, Eandi CM. Spectral domain-optical coherence tomography and fundus autofluorescence findings in a case of purtscher-like retinopathy. Retin Cases Brief Rep. 2011;5:167\u201370.","journal-title":"Retin Cases Brief Rep"},{"key":"3413_CR7","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1111\/j.1600-0420.2006.00851.x","volume":"85","author":"W Soliman","year":"2006","unstructured":"Soliman W, Zibrandtsen N, J\u00f8rgensen T, Sander B, Alsbirk P-H, Larsen M. Sequels of Purtscher\u2019s retinopathy imaged by enhanced optical coherence tomography. Acta Ophthalmol Scand. 2006;85:450\u20133.","journal-title":"Acta Ophthalmol Scand"},{"key":"3413_CR8","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s40942-021-00323-7","volume":"7","author":"R Venkatesh","year":"2021","unstructured":"Venkatesh R, Jayadev C, Sridharan A, Pereira A, Reddy NG, Cherry JP, et al. Internal limiting membrane detachment in acute central retinal artery occlusion: a novel prognostic sign seen on OCT. Int J Retina Vitreous. 2021;7:51.","journal-title":"Int J Retina Vitreous"},{"key":"3413_CR9","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s40942-022-00436-7","volume":"8","author":"M Jain","year":"2022","unstructured":"Jain M, Narayanan R, Barik B, Sahoo NK, Raval V, Reddy NG. Internal limiting membrane detachment in acute central retinal artery occlusion: clinical features, multimodal imaging, outcomes & prognostic biomarker. Int J Retina Vitreous. 2022;8:86.","journal-title":"Int J Retina Vitreous"},{"key":"3413_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/eye.2012.222","volume":"27","author":"AIM Miguel","year":"2013","unstructured":"Miguel AIM, Henriques F, Azevedo LFR, Loureiro AJR, Maberley DAL. Systematic review of Purtscher\u2019s and purtscher-like retinopathies. Eye. 2013;27:1\u201313.","journal-title":"Eye"},{"key":"3413_CR11","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1136\/bjo.73.8.677","volume":"73","author":"D Roden","year":"1989","unstructured":"Roden D, Fitzpatrick G, O\u2019Donoghue H, Phelan D. Purtscher\u2019s retinopathy and fat embolism. Br J Ophthalmol. 1989;73:677\u20139.","journal-title":"Br J Ophthalmol"},{"key":"3413_CR12","first-page":"52","volume":"25","author":"D Sellami","year":"2002","unstructured":"Sellami D, Ben Zina Z, Jelliti B, Abid D, Feki J, Cha\u00e2bouni M. [Purtscher-like retinopathy in systemic lupus erythematosus. Two cases]. J Fr Ophtalmol. 2002;25:52\u20135.","journal-title":"J Fr Ophtalmol"},{"key":"3413_CR13","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1097\/00006982-199717030-00011","volume":"17","author":"JC Lai","year":"1997","unstructured":"Lai JC, Johnson MW, Martonyi CL, Till GO. Complement-induced retinal arteriolar occlusions in the cat. Retina. 1997;17:239\u201346.","journal-title":"Retina"},{"key":"3413_CR14","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s40942-023-00475-8","volume":"9","author":"R Mangla","year":"2023","unstructured":"Mangla R, Venkatesh R, Sangoram R, Acharya I, Parmar Y, Prabhu V, et al. Retinal OCT findings in acute central retinal artery occlusion of varying severity at different disease stages - a retrospective, observational study. Int J Retina Vitreous. 2023;9:37.","journal-title":"Int J Retina Vitreous"},{"key":"3413_CR15","first-page":"330","volume":"25","author":"C Atabay","year":"1993","unstructured":"Atabay C, Kansu T, Nurlu G. Late visual recovery after intravenous methylprednisolone treatment of Purtscher\u2019s retinopathy. Ann Ophthalmol. 1993;25:330\u20133.","journal-title":"Ann Ophthalmol"},{"key":"3413_CR16","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1172\/JCI109365","volume":"63","author":"DE Hammerschmidt","year":"1979","unstructured":"Hammerschmidt DE, White JG, Craddock PR, Jacob HS. Corticosteroids inhibit complement-induced granulocyte aggregation. A possible mechanism for their efficacy in shock states. J Clin Invest. 1979;63:798\u2013803.","journal-title":"J Clin Invest"}],"container-title":["BMC Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03413-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12886-024-03413-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03413-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:02:29Z","timestamp":1711497749000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcophthalmol.biomedcentral.com\/articles\/10.1186\/s12886-024-03413-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3413"],"URL":"https:\/\/doi.org\/10.1186\/s12886-024-03413-w","relation":{},"ISSN":["1471-2415"],"issn-type":[{"type":"electronic","value":"1471-2415"}],"subject":[],"published":{"date-parts":[[2024,3,27]]},"assertion":[{"value":"13 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for utilising his clinical details for this manuscript. Permission for using the patient data for this report was obtained from Narayana Nethralaya institutional review board and ethics committee (C\/2023\/10\/03).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"137"}}