Cryoglobulinemia revealed by a Purtscher-like retinopathy

Arnaud Sauer¹, Xavier Nasica², Frédérique Zorn³, Philippe Petitjean⁴, Patrick Bader⁵, Claude Speeg-Schatz¹, Patrick Lenoble²

¹Department of Ophthalmology, Hôpitaux universitaires de Strasbourg, Strasbourg, France; ²Department of Ophthalmology, Centre hospitalier de Mulhouse, France; ³Department of Cardiology, Hôpitaux universitaires de Strasbourg, France; ⁴Department of Nephrology, Centre hospitalier de Mulhouse, France; ⁵Department of hepatology, Centre hospitalier de Mulhouse, France

Purpose: To demonstrate the importance of collaboration between ophthalmologists and internists.

Design: Cryoglobulinemia is a systemic vascularite. Ophthalmologic complications are rare and not well known. Purtscher-like retinopathy may occur in this context.

Case report: We report the case of a patient who presented a severe visual loss in the course of a hepatitis C. The ophthalmic examination shows a both ischemic and hemorrhagic bilateral retinopathy called Purtscher-like retinopathy. Cryoglobulinemia complicating a hepatitis C was discovered in our patient.

Conclusions: This case illustrates a cryoglobulinemia complicating by a Purtscher-like retinopathy. The diagnosis has been possible thanks to collaboration between ophthalmologists and internists.

We propose a few hypotheses to explain retinopathy pathogeny.

Keywords: cryoglobulinemia, hepatitis C, Purtscher-like retinopathy, visual loss