November 1975

Purtscher Retinopathy in the Battered Child Syndrome

Author Affiliations

From the departments of pediatrics and neurology (Pediatric Neurology), Boston University School of Medicine, Boston City Hospital. Dr Tomasi is now with the Waisman Center on Mental Retardation and Human Development, University of Wisconsin, Madison.

Am J Dis Child. 1975;129(11):1335-1337. doi:10.1001/archpedi.1975.02120480051012

• Purtscher retinopathy is a hemorrhagic angiopathy that occurs after sudden compression of the thorax. Virtually all reported cases have been in adults who have decreased visual acuity, retinal hemorrhages and exudates, and no other neurological signs. By contrast, in infants, hemorrhagic retinopathy is rarely benign, and generally is considered to indicate intracranial hemorrhage, usually an acute subdural hematoma.

Two battered infants had seizures and associated chest injury. There were retinal hemorrhages and exudates, unaccompanied by clinically important intracranial hemorrhage. At follow-up, the hemorrhagic retinopathy had resolved without sequelae; development was normal, and seizures had not recurred.

Purtscher retinopathy thus should be added both to the differential diagnosis of hemorrhagic retinopathy in infancy and to the list of physical signs suggesting child abuse.

(Am J Dis Child 129:1335-1337, 1975)