NOVEL RETINAL COMPLICATIONS AFTER ENDOSCOPIC SINUS SURGERY
Khalid Al Rubaie1, Augusto V Cruz, Mizher Al Ghamdi
1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Purpose:
To report a novel intraocular complication of endoscopic sinus surgery.
Methods:
Retrospective case report.
Results:
A 44-year-old otherwise-healthy man underwent endoscopic right ethmoid sinus surgery and immediately developed loss of vision in his right eye. Postoperatively, patient had ipsilateral light perception vision, proptosis, periorbital ecchymosis, and large angle exotropia with virtually no adduction. Orbital computed tomography confirmed violation of the right medial rectus muscle and optic nerve. Dilated fundus examination showed a macular fold with edema and hemorrhages, blockage on angiography of the macula, and subretinal hyperfluorescence in the periphery. After 6 months of observation, his central vision had improved to 20/300 with macular atrophy and choroidal atrophy in the periphery.
Conclusion:
Macular edema, nonperfusion and ischemia, choroidal nonperfusion (Amalric sign), and atrophy can be iatrogenic sequelae of endoscopic ethmoid sinus surgery.
