Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome

• Published in: European journal of ophthalmology Vol. 30; no. 3; p. NP14
• Main Authors: Santamaría Álvarez, Juan Francisco, Serret Camps, Anna, Aguayo Alvarez, Javier, García García, Olga
• Format: Journal Article
• Language: English
• Published: United States 01.05.2020
• Subjects: Antibodies, Monoclonal, Humanized - therapeutic use; Atypical Hemolytic Uremic Syndrome - complications; Atypical Hemolytic Uremic Syndrome - diagnosis; Atypical Hemolytic Uremic Syndrome - drug therapy; Complement Inactivating Agents - therapeutic use; Computed Tomography Angiography; Fluorescein Angiography - methods; Follow-Up Studies; Humans; Male; Retinal Diseases - diagnosis; Retinal Diseases - drug therapy; Retinal Diseases - etiology; Tomography, Optical Coherence - methods; Visual Acuity; Young Adult; Optic coherence tomography angiography; Purtscher-like retinopathy; eculizumab
• ISSN: 1724-6016
• DOI: 10.1177/1120672119833277

To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab. A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient's right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement. Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.