Acute retinal necrosis following epidural steroid injections.
OBJECTIVE
To report a side effect of epidural corticosteroid injections for back pain.


METHODS
Case series.


METHODS
Review of clinical charts and photographs.


METHODS
Private retina practice.


RESULTS
Two patients developed acute retinal necrosis syndrome following epidural corticosteroid injections for back pain. Referral was delayed in one patient. One patient developed bilateral secondary rhegmatogenous retinal detachment, and both developed secondary macular pucker.


CONCLUSIONS
Acute retinal necrosis can follow epidural corticosteroid injections. Patients should be warned about this possibility and advised to report should photopsias, photosensitivity, blurred vision, or new floaters develop after treatment. Orthopedists should be aware of the complication and promptly refer patients with symptoms for dilated fundus examination by an ophthalmologist.
Browning
David J
DJ
Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, North Carolina, USA. djbrowning@carolina.rr.com
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006561:Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000502:physiology; D018258:Herpesvirus 2, Human / Q000502:physiology; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007268:Injections, Epidural; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D012163:Retinal Detachment / Q000821:virology; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D014775:Virus Activation / Q000187:drug effects*
D000914:Antibodies, Viral; D000998:Antiviral Agents; D005938:Glucocorticoids; D007074:Immunoglobulin G; D000212:Acyclovir