CONTRALATERAL VISION LOSS AFTER ENDONASAL DACRYOCYSTORHINOSTOMY: A CASE REPORT OF PURTSCHER-LIKE RETINOPATHY AND TREATMENT WITH INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR

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Abstract

Purpose:

To present a case of a patient with contralateral vision loss as a result of Purtscher-like retinopathy after an endonasal dacryocystorhinostomy and treatment with intravitreal tissue plasminogen activator injection.

Methods and Results:

A 51-year-old woman who underwent a left endonasal dacryocystorhinostomy was referred with a complaint of decreased vision 1 day after surgery in her right eye. At the initial examination, the visual acuity of her right eye was hand motion. The fundoscopic examination revealed a premacular hemorrhage, diffuse intraretinal hemorrhages, multiple peripapillary cotton wool patches, and Purtscher flecken. The patient received 50 μg/0.1 mL of intravitreal tissue plasminogen activator injection. One day after the injection, visual acuity improved to 3/20. On 1-month follow-up without medication, the visual acuity improved to 6/20, and normal visual evoked potential latencies and amplitudes were detected.

Conclusion:

Purtscher- like retinopathy may occur as a complication of endonasal dacryocystorhinostomy. Intravitreal tissue plasminogen activator may help relieve the embolization that occurs in Purtscher-like retinopathy.

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