Sequential multifocal electroretinogram findings in a case of Purtscher-like retinopathy

PURPOSE: To report the multifocal electroretinographic findings of a patient with pancreatitis-associated Purtscher-like retinopathy. DESIGN: Observational case report. METHODS: A 20-year-old man with a history of alcohol abuse and acute pancreatitis underwent multifocal electroretinography (mfERG; 103-scaled hexagons, 8-minute recording time) at 1 week, 4 weeks, and 6 months after the onset of the retinopathy. RESULTS: At 1 week, the patient had extensive cotton- wool spots in the posterior pole bilaterally, and visual acuity was significantly reduced. Both the A-waves and B-waves of the mfERG were depressed in the corresponding areas. At 4 weeks, neither visual acuity nor mfERG showed improvement, although the cotton-wool spots had resolved. Interestingly, at 6 months, visual acuity had improved significantly in the left eye, consistent with increased ratios of mfERG responses for the central area. CONCLUSION: There was no selective reduction of b-waves of the mfERG as anticipated in isolated inner retinal pathology. In this case, both the A-waves and B-waves were reduced, suggesting damage to both outer and inner retinal layers.