Consequences of Purtscher-Like Retinopathy in a Patient With Systemic Lupus Erythematosus: A Case Report

We report on a case of Purtscher-like retinopathy (PLR) secondary to systemic lupus erythematosus, which caused retinal ischemia, retinal neovascularization, vitreous hemorrhage, and, ultimately, a combined tractional and rhegmatogenous retinal detachment. A 23-year-old male presented with decreased visual acuity in the left eye (OS). He had a recent history of systemic lupus erythematosus and was being treated with systemic corticosteroids. At presentation, his visual acuity was counting fingers in the OS; a fundus examination of the OS revealed the presence of macular edema associated with flame hemorrhages, diffuse cotton-wool spots surrounding the macula, and vascular sheathing with the retina attached, all of which were consistent with PLR. Five months later, his fundus examination (OS) showed severe retinal ischemia and active neovascularization. The patient was scheduled for pan-retinal photocoagulation (PRP) laser therapy, but he was lost to follow-up. Subsequently, he returned two months later with progressive damage and was treated with PRP in the OS. An additional two months after PRP treatment, an examination revealed combined tractional and rhegmatogenous retinal detachment. Ultimately, the patient required a pars plana vitrectomy.