Acute bilateral vitreo-retinal hemorrhages following oxygen-ozone therapy for lumbar disk herniation.
OBJECTIVE
To describe a case of acute bilateral intraocular hemorrhages occurring after injection of oxygen-ozone (O(2)O(3)) mixture.


METHODS
Observational case report.


METHODS
A 45-year-old woman complained about acute bilateral visual loss after intradiscal and periganglionic injection of gas mixture (O(2)O(3)) for lumbar disk herniation. Detailed ophthalmologic examination; magnetic resonance imaging (MRI) of brain and spinal cord; and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser membranotomy in the left eye was performed.


RESULTS
Ophthalmoscopy revealed a premacular hemorrhage involving the left macula. In the right eye multiple, flat, retinal hemorrhages around the optic disk and the posterior pole were observed. The MRI scan for intracranial hemorrhage was unremarkable. Drainage of the left premacular hemorrhage by pulsed Nd:YAG laser was obtained a few weeks later.


CONCLUSIONS
Retinal hemorrhages seem to be an uncommon but significant complication of intradiscal O(2)O(3) infiltration, and we suggest that it should be carefully considered when recommending this procedure.
Lo Giudice
Giuseppe
G
Department of Ophthalmology, University of Padua, Via Giustiniani 2, 35100 Padua, Italy. gvofta@libero.it
Valdi
Franco
F
Gismondi
Maurizio
M
Prosdocimo
Giovanni
G
de Belvis
Valentina
V
D000208:Acute Disease; D004359:Drug Therapy, Combination; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000628:therapy*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010100:Oxygen / Q000009:adverse effects* / Q000627:therapeutic use; D010126:Ozone / Q000009:adverse effects* / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D014823:Vitreous Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery
D010126:Ozone; D010100:Oxygen