Bilateral retinal artery and choriocapillaris occlusion following the injection of long-acting corticosteroid suspensions in combination with other drugs: I. Clinical studies.
Two well-documented cases of bilateral retinal artery and choriocapillaris occlusions with blindness following head and neck soft-tissue injection with methylprednisolone acetate in combination with lidocaine, epinephrine, or penicillin are reported. One case had only a unilateral injection. The acute observations included hazy sensorium, superior gaze palsy, pupillary abnormalities, and conjunctival hemorrhages with edema. Follow-up changes showed marked visual loss, constricted visual fields, optic nerve pallor, vascular attenuation, and chorioretinal atrophy. The literature is reviewed, and possible causes are discussed.
D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects; D001766:Blindness / Q000139:chemically induced*; D002196:Capillaries / Q000187:drug effects*; D002829:Choroid / Q000098:blood supply*; D003692:Delayed-Action Preparations / Q000009:adverse effects; D004617:Embolism / Q000139:chemically induced* / Q000150:complications; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects*; D012161:Retinal Artery / Q000187:drug effects*; D013535:Suspensions
D003692:Delayed-Action Preparations; D010406:Penicillins; D013535:Suspensions; D008012:Lidocaine; D008775:Methylprednisolone; D004837:Epinephrine