Orbital cellulitis complicated by central retinal artery occlusion

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Infectious Diseases

Background:

• Orbital cellulitis is a common infection in children, typically treated with antibiotics.
• Central retinal artery occlusion (CRAO) is a rare but severe complication affecting vision.
• CRAO has not been previously reported in pediatric cases of orbital cellulitis.

Observation:

• A 16-year-old male presented with severe orbital cellulitis, decreased vision, and an afferent pupillary defect.
• Initial intravenous antibiotic therapy was ineffective in improving the patient's condition.
• Ocular examination under anesthesia revealed retinal ischemia, confirmed as CRAO via fluorescein angiography.

Findings:

• Endoscopic orbital decompression was performed, leading to slight visual improvement after infection resolution.
• This case represents the first reported instance of central retinal artery occlusion secondary to orbital cellulitis in a pediatric patient.
• The rarity of this complication in children underscores the need for heightened clinical suspicion.

Implications:

• Early recognition and aggressive management, including surgical intervention, may be crucial for preserving vision in pediatric orbital cellulitis with CRAO.
• This case expands the known spectrum of orbital cellulitis complications.
• Further research is warranted to understand the pathophysiology and optimal treatment strategies for pediatric CRAO in this context.