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Purtscher-like retinopathy as the manifestation of adult Still’s disease

2025/10/02 by Maria Lourdes Castro de Oliveira Figueiroa, Castro de Oliveira Figueiroa, Maria Lourdes, Ricardo Danilo Chagas Oliveira +11
Medicine · #Kawasaki Disease and Coronary Complications #Medicine and health #Ocular Diseases and Behçet’s Syndrome #Purtscher-like retinopathy #Retinal and Optic Conditions #adult-onset Still’s disease #infliximab #ocular involvement

paper · doi:10.3205/oc000257

openalex publication_date 2025/10/02 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/01

Abstract

Adult Still's disease (ASD) is a rare systemic inflammatory disorder for which ocular manifestations have rarely been described. We report a case of 38-year-old Brazilian woman with Purtscher-like retinopathy as a manifestation of ASD. She was diagnosed with Purtscher-like retinopathy based on fundoscopic findings, which revealed vasculitis with diffuse and bilateral perimacular cotton-wool exudates. She also presented with fever, arthritis, weight loss, and a diffuse cutaneous rash. Considering the severity of the retinopathy, she was initially treated with methylprednisolone pulse therapy and oral methotrexate, and later with infliximab, with the treatment changing due to partial recovery of vision loss. Purtscher-like retinopathy is a poor prognostic factor for ASD, as it can lead to permanent visual damage. Thus, early and aggressive immunosuppressive therapy is mandatory.

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