I CANNOT SEE YOUR FACE! A CASE OF PURTSCHER DISEASE

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Purtscher-like retinopathy is an acquired form of due to hemorrhagic or vasoocclusive vasculopathy associated with acute pancreatitis and other systemic diseases 1. It severe vision. Recent studies suggested ophthalmoscopy performed within first 24 hours developing was a good indicator for predictor disease evolution, outcome overall poor prognosis 2. We present rare case young African American male who had experienced vision loss in the setting alcoholic pancreatitis. CASE PRESENTATION: 34-year-old history dependence presents abdominal pain. His last drink 36 ago. It's described as sharp radiating his back. He denies any ingestions drug use. On presentation, vital signs show that he mildly hypertensive, but otherwise normal limits. Physical exam reveals epigastric tenderness on palpation positive bowel signs, negative murphy sign, cullens sign gray turners sign. Labs were significant elevated lipase well liver enzymes. No osmolar gap. Intravenous fluids provided pain control patient placed withdrawal assessment scale. Within 12 admission, started experience hallucinosis decreased visual acuity inability recognize facial features. Fundoscopy revealed retinal whitening bilaterally, Intraretinal flame heme along inferior arcade right eye, cherry red spot left eye macula, consistent declaring him legally blind. Patient signed 302 receive further inpatient psychiatric care. DISCUSSION: The patient's psychosis from alcohol compounded complaint loss. Purtscher complication etiology unclear, however relation pancreatitis, condition may be caused by complement induced granulocyte activity causing cotton wool spots, hemorrhages, papilledema [2]. should suspected if patients voice concern acuity. Previously high dose steroids have been used there no evidence this treatment improves morbidity. Recovery variable some regaining mild others remain Certainly, interesting CONCLUSIONS: Evaluation complaints raise Purtcher's retinopathy. There are current evidence-based options. Close follow up specialist required. Further clinical required investigate options REFERENCE #1: Bissonnette B. Disease. AccessAnesthesiology 2019. #2: C; CDRABFB. [Retinopathy pancreatitis]. Oftalmologia (Bucharest, Romania : 1990). #3: Buckley, S. James, B., 2020. [online] Pmj.bmj.com. Purtschers Retinopathy. [Accessed 7 July 2020]. DISCLOSURES: relevant relationships Abdelrhman Abo-zed, source=Web Response Melissa Chrites, Erica OKane, Syed Arsalan Zaidi,