[Retinopathy in severe acute pancreatitis]

Abstract

Retina examination performed in patients with severe acute pancreatitis showed intra and peri-retinal hemorrhages. They were associated with cottonwool exsudates induced by micro-infarction of the retina and the optic nerve similary to the Purtscher retinopathy. This feature of the retina examination indicates a severe outcome due to the multiple organ failure syndromes. This condition mainly developed in young male patients between 36 and 56 years of age. In 2 patients with septic shock, acute hemorrhagic retinopathy was identified within the first 24 hours and the patients died after a few days, while for other 3 patients with septic shock the outcome was also death after a few weeks. For 9 patients with severe sepsis, examination of retina showed perivascular exudates and vascular occlusion subsequently leading to partial optic atrophy; examination of other 6 mild sepsis patients did not show any retinal abnormalities. Ophthalmoscopy performed within the first 24 hours for patients with severe acute pancreatitis is a predictor of disease evolution and outcome.