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PARACENTRAL ACUTE MIDDLE MACULOPATHY AND OCULAR ISCHEMIC SYNDROME AFTER INTRANASAL STEROID INJECTION: A CASE REPORT
Jessica E Weinstein1, Margaret A Greven2
1Department of Ophthalmology and Visual Sciences, University of Kentucky, Lexington, Kentucky; and.
Purpose:
To describe a case of paracentral acute middle maculopathy and ocular ischemic syndrome after intranasal steroid injection.
Methods:
Case report.
Results:
Following an intranasal steroid injection, the patient experienced an episode of amaurosis fugax in her right eye lasting several minutes. Afterward, her visual acuity returned to baseline, but she noted a persistent central scotoma. Optical coherence tomography demonstrated paracentral acute middle maculopathy and fluorescein angiography showed staining and leakage to peripheral vessels concerning for diffuse ischemia.
Conclusion:
Steroid injections to the face and nasopharynx may result in ischemic and vaso-occlusive events in the retina. Ophthalmologists and other physicians performing these procedures need to be aware of this potential adverse outcome.
Insights
Intranasal steroid injections can cause vision loss, including paracentral acute middle maculopathy and ocular ischemic syndrome. Awareness is crucial for physicians to prevent potential adverse outcomes in patients.
Area of Science:
- Ophthalmology
- Endocrinology
Background:
- Intranasal steroid injections are commonly used for various nasopharyngeal conditions.
- Potential adverse effects, particularly ocular complications, require thorough investigation.
Approach:
- This study presents a case report detailing a patient's experience following an intranasal steroid injection.
- Diagnostic methods included optical coherence tomography and fluorescein angiography.
Key Points:
- The patient developed transient amaurosis fugax and a persistent central scotoma in the right eye.
- Optical coherence tomography revealed paracentral acute middle maculopathy.
- Fluorescein angiography indicated diffuse ischemia with peripheral vessel staining and leakage.
Conclusions:
- Intranasal steroid injections may precipitate retinal ischemic and vaso-occlusive events.
- Ophthalmologists and other clinicians must be aware of this potential risk associated with facial and nasopharyngeal steroid injections.
