Background: To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and\nOCT angiography (OCT-A) findings before and after treatment.\nCase presentation: A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination\nrevealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right\neye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT\npresented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute\nmiddle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and\nchoriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed\nresolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern\nturned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the\nchoriocapillaris.\nConclusion: This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the\nchoriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.
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