Treatment options utilized.

Background
To describe Purtscher’s and Purtscher-like retinopathy clinical features, etiologies, management options, and visual outcomes.
Methods
Our protocol was registered on PROSPERO [registration number: CRD42023406843]. Seven online databases were searched: PubMed, Scopus, Medline, ScienceDirect, CENTRAL, clinicaltrials.gov, and Google Scholar. Original articles were included if they reported at least one subject diagnosed with Purtscher’s or Purtscher-like retinopathy. The primary outcome is to describe the clinical features of Purtscher and Purtscher-like retinopathies, including etiologies, results of related investigations, management lines, and visual outcomes. All analyses were conducted with the use of Statistical Package for Social Sciences (SPSS) version 27 (IBM SPSS Corp, SPSS Statistics ver. 26, USA) and Cochrane’s RevMan software. The methodological quality of included studies was assessed using the NIH quality assessment tools.
Results
A total of 114 articles were included, describing 168 cases of Purtscher’s and Purtscher-like retinopathy. Patients were evenly distributed between males (50.89%) and females (49.11%). Average age of patients was 34.62 years old. Trauma was the leading cause of retinopathy, being reported in 39.88% of our patients, followed by systemic lupus erythematosus (SLE) (13.1%) and acute pancreatitis (11.9%). Bilateral symptoms were reported in 57.7% of patients with centrally blurred vision being the most complained symptom (OS: 34.32% and OD: 18%). 75% of patients elicited bilateral retinal findings. Cotton-wool spots were of highest prevalence (58%). Purtscher flecken was seen in 53% of patients. Macular edema was seen in 13% of patients. Overall, patients had a favorable prognosis (53%).
Conclusion
Purtscher’s and Purtscher-like retinopathies are rare sight-threatening retinopathies that develop most commonly following trauma or other systemic diseases as SLE and acute pancreatitis. Little data is available regarding these conditions, and available data is of low quality. Patients develop bilateral disease in approximately 50% of cases, and several retinal findings are observed, with no specific tendency. Most observed signs are cotton-wool spots in around 55% of patients and Purtscher flecken in 51% of patients. Patients spontaneously recovered, although data is not conclusive. No clear prognostic value of etiological factors is identified, and further research is required in this regard.

背景
本研究旨在描述普尔茨舍（Purtscher）视网膜病变及类普尔茨舍视网膜病变的临床特征、病因、治疗方案与视觉预后。

方法
本研究方案已在PROSPERO平台注册（注册号：CRD42023406843）。检索了7个在线数据库：PubMed、Scopus、Medline、ScienceDirect、CENTRAL、clinicaltrials.gov及Google Scholar。纳入所有报告至少1例确诊为普尔茨舍或类普尔茨舍视网膜病变受试者的原创研究论文。本研究的主要结局指标为描述普尔茨舍及类普尔茨舍视网膜病变的临床特征，包括病因、相关检查结果、治疗策略及视觉预后。所有数据分析均采用社会科学统计软件包（Statistical Package for Social Sciences, SPSS）27.0版本（IBM SPSS公司，SPSS Statistics 26版，美国）及考克兰RevMan软件完成。采用美国国立卫生研究院（National Institutes of Health, NIH）质量评价工具对纳入研究的方法学质量进行评估。

结果
最终纳入114篇文献，共报道168例普尔茨舍及类普尔茨舍视网膜病变病例。患者性别分布均衡，男性占50.89%，女性占49.11%，平均年龄为34.62岁。外伤是该类视网膜病变的首要病因，占纳入患者的39.88%，其次为系统性红斑狼疮（SLE，13.1%）与急性胰腺炎（11.9%）。57.7%的患者出现双侧眼部症状，其中以中心视力模糊为最常见主诉（左眼OS占34.32%，右眼OD占18%）。75%的患者观察到双侧视网膜异常体征。棉絮斑检出率最高（58%），普尔茨舍斑检出率为53%，黄斑水肿检出率为13%。总体而言，53%的患者预后良好。

结论
普尔茨舍及类普尔茨舍视网膜病变属于罕见的威胁视力的视网膜病变，多继发于外伤或系统性红斑狼疮（SLE）、急性胰腺炎等全身性疾病。目前针对此类疾病的研究数据较少，且现有研究质量偏低。约50%的患者会出现双侧眼部病变，可观察到多种视网膜异常体征，无明显特异性分布。最常见的体征为棉絮斑（约55%的患者）与普尔茨舍斑（51%的患者）。尽管现有证据尚无定论，但多数患者可自发缓解。未明确病因因素与预后的明确关联，此领域仍需开展进一步研究。