Retinal and choroidal vascular occlusion secondary to corticosteroid embolisation.
We report a case of visual loss following intranasal injection of triamcinolone acetonide and phenylephrine hydrochloride in a 22-year-old female with chronic sinusitis. Clinical examination and fluorescein angiography revealed vascular occlusions which involved multiple small branches of both the choroidal and retinal circulations. The mechanism of such a complication probably involves inadvertent intra-arterial injection into the anterior or the posterior ethmoidal artery, with retrograde flow into the opthalmic arterial system. Precautions can be taken to avoid such complications.
Wilkinson
W S
WS
Vitreoretinal Services, WK Kellogg Eye Center, University of Michigan Medical Center, Ann Arbor.
Morgan
C M
CM
Baruh
E
E
Gitter
K A
KA
D000328:Adult; D002829:Choroid / Q000098:blood supply*; D004617:Embolism / Q000139:chemically induced*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections / Q000009:adverse effects; D010656:Phenylephrine / Q000008:administration & dosage; D012164:Retinal Diseases / Q000139:chemically induced; D012171:Retinal Vessels; D012852:Sinusitis / Q000188:drug therapy; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D014603:Uveal Diseases / Q000139:chemically induced
D010656:Phenylephrine; D014222:Triamcinolone Acetonide