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POSTOPERATIVE HEMORRHAGIC OCCLUSIVE RETINAL VASCULITIS: A FORME FRUSTE VARIANT?
Roger A Goldberg1, Courtney Crawford2, Jeffrey S Heier2
1Bay Area Retina Associates, Walnut Creek, California.
Retinal Cases & Brief Reports
|January 4, 2017
Summary
A mild variant of hemorrhagic occlusive retinal vasculitis (HORV) occurred after cataract surgery with vancomycin. This forme fruste HORV case highlights potential adverse effects of vancomycin in eye surgery.
Area of Science:
- Ophthalmology
- Retinal Vasculitis
- Surgical Complications
Background:
- Cataract surgery is a common procedure.
- Vancomycin is frequently used in ophthalmic irrigation solutions.
- Hemorrhagic occlusive retinal vasculitis (HORV) is a rare but severe complication.
Observation:
- A patient developed HORV after uneventful cataract surgery with vancomycin in the irrigating solution.
- Ultra-widefield fluorescein angiography confirmed occlusive vasculitis in both eyes.
- Systemic workup for coagulopathy and inflammation was negative.
Findings:
- The patient presented with a forme fruste variant of HORV.
- Visual acuity remained excellent (20/20) one year post-surgery without treatment.
- This outcome is significantly milder than previously reported HORV cases.
Implications:
- Ultra-widefield angiography aids in diagnosing milder HORV.
- Vancomycin exposure during cataract surgery may be linked to a higher incidence of HORV.
- Increased vigilance and reporting are crucial to understanding vancomycin-associated HORV risks.
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