title: Hemorrhagic occlusive retinal vasculitis after inadvertent intraocular perforation with gentamycin injection.
abstract: OBJECTIVE
  To report a case of hemorrhagic occlusive retinal vasculitis (HORV) secondary to intraocular toxicity due to inadvertent intraocular injection of gentamycin.
  
  
  METHODS
  A 21-year-old woman was referred to our department because of severe ocular pain and sudden visual loss in her left eye after she received a subconjunctival gentamycin injection for chronic infectious keratitis.
  
  
  RESULTS
  At presentation, best-corrected visual acuity was 20/20 in the right eye and counting fingers in the left eye. Fundus examination showed diffuse intraretinal and perivascular hemorrhages, vascular cuffing, white-centered hemorrhages, and diffuse retinal edema. Fluorescein angiography confirmed occlusive retinal vasculitis with capillary nonperfusion and spectral-domain optical coherence tomography revealed ischemic macular edema. The clinical diagnosis was compatible with HORV secondary to retinal toxicity due to high dose of intraocular gentamycin.
  
  
  CONCLUSIONS
  We report a case of HORV secondary to inadvertent subconjunctival gentamycin injection. Ocular perforation and high dose of intravitreal gentamycin administration should be considered as a potential cause of HORV following subconjunctival injection.
authors.affiliation: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors.forename: Lea
authors.initials: L
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Miserocchi
authors.affiliation: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Modorati
authors.affiliation: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001766:Blindness / Q000209:etiology; D003320:Corneal Ulcer / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology; D058447:Eye Pain / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005839:Gentamicins / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D056965:Injections, Intraocular; D016602:Needlestick Injuries / Q000175:diagnosis / Q000209:etiology*; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D031300:Retinal Vasculitis / Q000139:chemically induced* / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins