Blindness and acute pancreatitis: Purtscher‐like retinopathy

A 30‐year‐old woman was admitted for pancreatitis (peak lipase level, 1385 U/L; Ranson score, 2). Other than excess alcohol intake and previous smoking, she was well with no ocular history. Six hours after the onset of abdominal pain, there was rapid deterioration of central vision, with acuity dropping to 6/120 in both eyes. Fundoscopy demonstrated bilateral well defined areas of intraretinal whitening with perivascular sparing and cotton wool spots, consistent with Purtscher‐like retinopathy1 (Figure, A). Optical coherence tomography at acute presentation also demonstrated inner retinal swelling and disruption of layers (Figure, C). One‐month follow‐up showed resolution of the acute findings, with persistent mottled retinal pigment epithelium and retinal atrophy (Figure, B and D). Acuity remains < 6/60 in both eyes.