Hemorrhagic Occlusive Retinal Vasculitis After Inadvertent Intraocular Perforation With Gentamycin Injection

Eur J Ophthalmol. 2017 Mar 10;27(2):e50-e53. doi: 10.5301/ejo.5000874.

Abstract

Purpose: 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.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Blindness / etiology
  • Corneal Ulcer / drug therapy
  • Corneal Ulcer / microbiology
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology
  • Eye Pain / etiology
  • Female
  • Fluorescein Angiography
  • Gentamicins / adverse effects*
  • Humans
  • Iatrogenic Disease
  • Injections, Intraocular
  • Needlestick Injuries / diagnosis
  • Needlestick Injuries / etiology*
  • Retinal Hemorrhage / chemically induced*
  • Retinal Hemorrhage / diagnosis
  • Retinal Perforations / diagnosis
  • Retinal Perforations / etiology*
  • Retinal Vasculitis / chemically induced*
  • Retinal Vasculitis / diagnosis
  • Tomography, Optical Coherence
  • Visual Acuity / drug effects
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Gentamicins