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Retinal Vascular Occlusion Secondary to Retrobulbar Injection: Case Report and Literature Review.

Abstract Retrobulbar injection has been widely practiced as a technique of ocular anesthesia for many decades. Nevertheless, the technique is not free from complications. Vascular occlusion secondary to retrobulbar injection is rare but can be vision threatening. We report a case series of two such patients who presented with poor vision following retrobulbar injection. Fundus showed pale retina with cherry red spot suggestive of central retinal artery occlusion in case 1 and pale disc with sclerosed vessels and multiple superficial hemorrhages suggestive of a combined occlusion of retinal artery and vein in case 2. Optical coherence tomography (OCT) showed thickened inner retinal layers with intact outer retinal layers in case 1 and thinning in case 2. We conclude that retrobulbar injections can rarely be associated with dreadful vision-threatening complications like in our patients. We also report the role of OCT in assessing the prognosis following vascular occlusion.
PMID
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Authors

Mayor MeshTerms
Keywords

Combined occlusion

retrobulbar injection

vascular occlusion

Journal Title middle east african journal of ophthalmology
Publication Year Start




PMID- 28546695
OWN - NLM
STAT- MEDLINE
DA  - 20170526
DCOM- 20170615
LR  - 20170615
IS  - 0975-1599 (Electronic)
IS  - 0974-9233 (Linking)
VI  - 24
IP  - 1
DP  - 2017 Jan-Mar
TI  - Retinal Vascular Occlusion Secondary to Retrobulbar Injection: Case Report and
      Literature Review.
PG  - 57-60
LID - 10.4103/meajo.MEAJO_37_16 [doi]
AB  - Retrobulbar injection has been widely practiced as a technique of ocular
      anesthesia for many decades. Nevertheless, the technique is not free from
      complications. Vascular occlusion secondary to retrobulbar injection is rare but 
      can be vision threatening. We report a case series of two such patients who
      presented with poor vision following retrobulbar injection. Fundus showed pale
      retina with cherry red spot suggestive of central retinal artery occlusion in
      case 1 and pale disc with sclerosed vessels and multiple superficial hemorrhages 
      suggestive of a combined occlusion of retinal artery and vein in case 2. Optical 
      coherence tomography (OCT) showed thickened inner retinal layers with intact
      outer retinal layers in case 1 and thinning in case 2. We conclude that
      retrobulbar injections can rarely be associated with dreadful vision-threatening 
      complications like in our patients. We also report the role of OCT in assessing
      the prognosis following vascular occlusion.
FAU - Vasavada, Dhaivat
AU  - Vasavada D
AD  - Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of
      Ophthalmology, Puducherry, India.
FAU - Baskaran, Prabu
AU  - Baskaran P
AD  - Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of
      Ophthalmology, Puducherry, India.
FAU - Ramakrishnan, Seema
AU  - Ramakrishnan S
AD  - Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of
      Ophthalmology, Puducherry, India.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - India
TA  - Middle East Afr J Ophthalmol
JT  - Middle East African journal of ophthalmology
JID - 101521797
SB  - IM
MH  - Aged
MH  - Anesthesia, Local/*adverse effects/methods
MH  - Female
MH  - Fluorescein Angiography
MH  - Fundus Oculi
MH  - Humans
MH  - Middle Aged
MH  - Orbit
MH  - Retinal Artery/*diagnostic imaging
MH  - Retinal Artery Occlusion/diagnosis/*etiology
MH  - Retinal Vein/*diagnostic imaging
MH  - Retinal Vein Occlusion/diagnosis/*etiology
MH  - Tomography, Optical Coherence/methods
PMC - PMC5433131
OTO - NOTNLM
OT  - Combined occlusion
OT  - retrobulbar injection
OT  - vascular occlusion
COI - There are no conflicts of interest.
EDAT- 2017/05/27 06:00
MHDA- 2017/06/16 06:00
CRDT- 2017/05/27 06:00
AID - 10.4103/meajo.MEAJO_37_16 [doi]
AID - MEAJO-24-57 [pii]
PST - ppublish
SO  - Middle East Afr J Ophthalmol. 2017 Jan-Mar;24(1):57-60. doi:
      10.4103/meajo.MEAJO_37_16.