Purtscher's Like Retinopathy vs Vasculitis Consist with Familial Mediterranean Fever
A patient who presented with 2 weeks history of fever , abdominal pain, nausea/vomiting/diarrhea and recurrent urticarial rash , after recent travel to Singapore and India, developed bilateral painless vision loss. Visual acuity at presentation was 20/400 in right eye and CF in left eye without evidence of anterior chamber or vitreous cells found to have peripapillary hexagonal cotton wool spots in both eyes. There were retinal hemorrhage in both eyes and Purtscher –like retinopathy. Fluorescein angiogram demonstrated large vessels vasculitis and macular ischemia both eyes, OCT macula showed inner retinal hyperreflectivity consistent with ischemic process and fluctuating macular edema of both eyes .Severe occlusive retinal vasculitis secondary to biallelic MEFV gene mutation consistent with Familial Mediterranean Fever, treated with Systemic steroids, IMT, multiple lV Anti VEGEF injections OU ,multiple IV Dexamethasone injection OU, PRP OU , underwent cataract surgery extraction & IOL insertion OU, and PPV OD due to Vitreous hemorrhage, patient’s vision prognosis is guarded due to the severe retinal ischemic changes.
Presentation Date: 02/12/2026
Issue Date: 03/20/2026
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