Central retinal artery occlusion associated with periocular corticosteroid injection for juvenile hemangioma.
Intralesional corticosteroid injections are an accepted treatment for periocular juvenile hemangiomas. This treatment is felt to be relatively free of complications. We report, however, a case of central retinal artery occlusion associated with steroid injection for a periocular juvenile hemangioma in a four-year-old child. It is presumed that the force of injection or digital massage caused retrograde arterial flow, moving steroid suspension particles into the central retinal artery where vascular occlusion occurred. As a result of this case, our treatment regimen has been modified. We now use 0.1 cc steroid alloquats injected slowly through a 30-gauge needle and avoid firm digital pressure on the lesion.
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D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000139:chemically induced* / Q000473:pathology; D005134:Eye Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005138:Eyebrows; D005142:Eyelid Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005143:Eyelids; D005260:Female; D005654:Fundus Oculi; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D007267:Injections; D012161:Retinal Artery
D000305:Adrenal Cortex Hormones