Spectral domain optical coherence tomography in Celestone® retinal toxicity

After inadvertent intravitreal injection of Celestone® (betamethasone sodium phosphate and acetate, benzalkonium chloride) in a patient, the macular spectral domain optical coherence tomography (SD-OCT) images showed hyper-reflectivity, thinning, and irregular spikes in the inner retinal layers. These early findings could explain the toxic secondary anatomical changes due to the drug itself and/or to its excipients. Late and permanent SD-OCT findings included changes in the ellipsoid zone and cystic-like spaces.

In this case, SD-OCT images can help to better understand the pathophysiology of the retinal damage and to diagnose the associated complications, providing information with prognostic value.