Sudden visual impairment is a key characteristic of Purtscher's retinopathy. All reported cases involve individuals who experienced symptoms, like reduced visual acuity and visual field or a combination of both with the majority of the patients reporting combined defects of visual acuity and visual field . Extremely profound ocular dysfunction, such as sudden blindness, may also be induced, as can annular, central or paracentral scotomas and extensive defects occupying various segments of the visual field .
Ocular symptoms usually arise 1-2 days after a traumatic event or other acute, Purtscher's-retinopathy-related conditions   . The aforementioned defects associated with vision loss can be unilateral or bilateral.
Other features of Purtscher's retinopathy are due to the fact that it is strongly associated with extraocular trauma. So patients may present with evidence of head or thoracic injuries. Individuals who have developed the retinopathy without prior trauma may present with symptoms of a variety of other pathologies that have been associated with the condition. These include:
Fundoscopy is the first step towards achieving an accurate diagnosis of Purtscher's retinopathy. Findings consistent with this diagnosis include :
- Cotton-wool spots. These constitute restricted regions of retinal ischemia, which are observed as white areas of axonal swelling obstructing the axoplasmal flow and are detected in up to 90% of the cases  .
- Retinal hemorrhages may appear on the superficial nerve fiber, in which case they display a flame-like shape, or on the inner retinal layers; in the latter case, they assume a "dot and blot" pattern. They are also observed in up to 90% of the affected patients.
- "Purtscher flecken" are deemed pathognomonic for Purtscher's retinopathy but are detected in only half of the patients . Purtscher flecken are polygonal regions of whitening of the retina; it is believed that they occur due to regional capillary bed infarction.
- Normal optic disc, which tends to assume an edematous appearance later in the course of the disorder.
Another diagnostic modality that can be employed is fluorescein angiography. It is expected to illustrate regional ischemia of the retina and capillary bed, possibly accompanied by venous dilation and perivenous staining .
Given the fact that Purtscher's retinopathy is primarily associated with extraocular trauma, especially head or thoracic trauma, workup may include a radiograph or a computerized tomography scan (CT scan) of the affected region. In case the retinopathy is not induced by trauma, it may be linked to other diseases, such as acute pancreatitis, activated complement C5a, systemic lupus erythematosus, scleroderma, dermatomyositis and other pathologies. Therefore, laboratory tests that need to be performed to assess these possibilities encompass:
- Serum amylase, transaminase, myoglobin, aldolase, creatine phosphokinase, urine myoglobin
- Serum rheumatoid factor, ANA, anti-double-stranded DNA antibody
- Complement C5a levels
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