Triamcinolone emboli leading to central retinal artery occlusion: a multimodal imaging study

A 19-year-old man presented with unilateral sudden onset vision loss following an intra-articular triamcinolone injection in the right temporomandibular joint. At fundus examination emboli of triamcinolone were visible in multiple retinal arteries. Choroidal ischaemia and occlusion of the central retinal artery and its branches were documented at fluorescein angiography. Optical coherence tomography revealed significant thickening of the inner retinal layers. Optical coherence tomography angiography clearly demonstrated an abrupt cut-off of flow in a vessel below the optic disc. Lack of perfusion of the superficial and deep retinal plexuses beyond the areas of embolisation and at the posterior pole was also appreciated. The visual outcome was poor despite treatment.