Rapid and progressive decline despite early intervention in a case of bilateral hemorrhagic occlusive retinal vasculitis
Autor: | Mahsaw Motlagh, Cameron Javid |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Visual acuity genetic structures medicine.medical_treatment Case Report Neovascular glaucoma Endophthalmitis lcsh:Ophthalmology Intracameral antibiotics Intervention (counseling) Ophthalmology Medicine business.industry Retinal vasculitis Occlusive Cataract surgery medicine.disease eye diseases Hemorrhagic occlusive retinal vasculitis lcsh:RE1-994 Vitreous hemorrhage sense organs medicine.symptom business Complication |
Zdroj: | American Journal of Ophthalmology Case Reports, Vol 17, Iss, Pp-(2020) American Journal of Ophthalmology Case Reports |
ISSN: | 2451-9936 |
Popis: | Purpose: To present a case of severe bilateral hemorrhagic occlusive retinal vasculitis (HORV) after uncomplicated cataract surgery with intracameral vancomycin. We present a report of a single patient with bilateral presentation of HORV that demonstrated classic features of the disease and progressed to profound vision loss despite early and aggressive intervention. Observations: On initial presentation, the patient had good Snellen visual acuity of 20/25 PH 20/20 OD and 20/60 PH 20/30 OS with retinal hemorrhages in both eyes and sub-hyaloid hemorrhage in the left eye. Early therapeutic intervention with intravitreal corticosteroids, anti-vascular endothelial growth factor (anti-VEGF) agents and oral steroids was pursued. Even with treatment, the clinical picture rapidly deteriorated with progression of occlusive and hemorrhagic complications in both eyes resulting in bilateral ischemic retinopathy and breakthrough vitreous hemorrhage. After a prolonged course of treatment including the aforementioned along with panretinal photocoagulation (PRP) in both eyes and vitreoretinal surgery in the left eye, the final visual acuity was light perception (LP) OD and 20/100 OS. Conclusions and importance: Hemorrhagic occlusive retinal vasculitis remains a feared complication of uncomplicated cataract surgery utilizing intracameral vancomycin. Despite early recognition and appropriate intervention, our patient still had a poor visual outcome with significant ischemic damage. Keywords: Hemorrhagic occlusive retinal vasculitis, Intracameral antibiotics, Endophthalmitis, Neovascular glaucoma |
Databáze: | OpenAIRE |
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