Unilateral Purtscher's retinopathy

We report herein a case of a 17-year-old male who presented status postmotor vehicle accident resulting in severe polytrauma and reduced visual acuity in his right eye (OD). Best-corrected visual acuity (BCVA) was 20/400 OD and 20/20 in his left eye (OS). Slit-lamp examination confirmed normal anterior segment anatomy in both eyes (OU). Indirect ophthalmoscopy and subsequent fluorescein angiography confirmed the presence of multiple cotton-wool spots, intraretinal hemorrhages, a well-circumscribed area of macular whitening, and vascular tortuosity throughout the posterior pole and peripapillary region, all suggestive of an arterio-occlusive event OD, with a normal fundus examination OS. Imaging of the macula with optical coherence tomography demonstrated hyperreflectivity of the inner retina, along with subfoveal irregularities of the outer retinal segments OD. Systemic steroid therapy was initiated, and after 1 month, BCVA improved to 20/70 OD.