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Haemorrhagic occlusive retinal vasculitis caused by intravitreal vancomycin
Javeria Muid1, Muhammad Amer Awan1
1Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan.
JPMA. the Journal of the Pakistan Medical Association
|October 11, 2020
Summary
Intraocular Vancomycin, used for endophthalmitis, can cause rare but severe vision loss due to ischaemic vasculitis. This complication, even after vitrectomy, highlights the toxic potential of intravitreal Vancomycin.
Area of Science:
- Ophthalmology
- Vascular Medicine
Background:
- Intraocular Vancomycin is a common treatment and prophylaxis for endophthalmitis.
- Rarely, it can lead to severe ocular complications like ischaemic vasculitis.
Observation:
- Two patients developed painless visual loss and haemorrhagic occlusive retinal vasculitis (HORV) after intravitreal Vancomycin for suspected endophthalmitis post-cataract surgery.
- Clinical signs included anterior chamber inflammation and peripheral retinal haemorrhages.
Findings:
- Despite vitrectomy to remove lenticular matter, both patients experienced profound visual loss.
- The cases demonstrate the significant toxic potential of intraocular Vancomycin.
Implications:
- This highlights the need for careful consideration of Vancomycin's risks in intraocular use.
- Alternative prophylactic or treatment strategies may be warranted to prevent vision-threatening complications.
