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Bisected macula following retrobulbar steroid injection
S Parikh1, M P Shanmugam, J Biswas
1Medical and Vision Research Foundation, Chennai, India.
Indian Journal of Ophthalmology
|July 13, 2000
Summary
Accidental globe penetration during retrobulbar steroid injection for optic neuritis occurred bilaterally. One eye recovered vision after vitrectomy and laser treatment for a bisected macula, while the other suffered permanent blindness from central retinal artery occlusion.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Neuro-ophthalmology
Background:
- Optic neuritis is an inflammatory condition affecting the optic nerve, often treated with corticosteroids.
- Retrobulbar injections are a method of drug delivery near the optic nerve.
- Accidental globe penetration is a rare but serious complication of retrobulbar injections.
Observation:
- A case involving bilateral accidental globe penetration during retrobulbar steroid administration for bilateral optic neuritis.
- One eye presented with a bisected macula, a severe retinal injury.
- The fellow eye exhibited signs of central retinal artery occlusion, leading to blindness.
Findings:
- Successful management of the bisected macula was achieved through vitrectomy, internal gas tamponade, and laser photocoagulation of the retinal tear edges.
- The fellow eye, despite treatment, remained blind due to the irreversible damage from central retinal artery occlusion.
Implications:
- This case highlights the critical risks associated with retrobulbar injections, even when performed for sight-threatening conditions like optic neuritis.
- Prompt and appropriate surgical intervention, including vitrectomy and laser, can salvage vision in cases of macular trauma.
- Central retinal artery occlusion following globe penetration represents a devastating outcome, emphasizing the need for meticulous surgical technique and awareness of potential complications.