Spectral domain optical coherence tomography in Celestone® retinal toxicity.

Area of Science:

• Ophthalmology
• Retinal Imaging
• Toxicology

Background:

• Intravitreal injections are common ophthalmic procedures.
• Celestone® (betamethasone sodium phosphate and acetate, benzalkonium chloride) is a corticosteroid formulation.
• Accidental intravitreal injection can lead to ocular complications.

Observation:

• Spectral domain optical coherence tomography (SD-OCT) was used to image the macula following inadvertent intravitreal injection.
• Early SD-OCT findings included inner retinal layer hyper-reflectivity, thinning, and irregular spikes.
• Late SD-OCT findings revealed changes in the ellipsoid zone and cystic-like spaces.

Findings:

• The observed SD-OCT changes suggest toxic secondary anatomical alterations caused by Celestone® or its excipients.
• Early and late imaging findings correlate with drug-induced retinal damage.
• Specific OCT patterns indicate the severity and progression of retinal toxicity.

Implications:

• SD-OCT is crucial for diagnosing and understanding the pathophysiology of drug-induced retinal toxicity.
• These imaging findings provide valuable prognostic information for patients experiencing inadvertent intravitreal injections.
• This case highlights the importance of careful injection technique and awareness of potential corticosteroid-related retinal complications.