Akute Visusminderung nach parabulbärer Triamcinolonacetonid-Injektion

Anamnese und Befund

Ein 58-jähriger Mann wurde uns wegen zunehmender Visusminderung und Metamorphopsien links zur operativen Behandlung überwiesen. Bei einer linksseitigen epiretinalen Gliose ([Abb. 1 a]), Cataracta provecta und oberflächlichen Hornhautnarben nach Contusio bulbi (15 Jahre zuvor) lag der Visus links cum correctione (cc) bei 0,4, rechts cc bei 1,0. Der Augeninnendruck war beidseits normwertig (16/14 mmHg). Rechts lag ein regelrechter vorderer Augenabschnitts- und Fundusbefund vor.

Publication History

Received: 06 January 2024

Accepted: 02 June 2024

Article published online:
03 July 2024

• Literatur

• 1 Feltgen N, Ochmann T, Hoerauf H. Internistische Abklärung bei retinalen Gefäßverschlüssen. Ophthalmologie 2023; 120: 1287-1294
• 2 Kodjikian L, Bellocq D, Bodaghi B. Management of Irvine-Gass syndrome. J Fr Ophtalmol 2017; 40: 788-792
• 3 Obis J, Arias L, Lorenzo D. et al. Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema. BMC Ophthalmol 2021; 21: 387
• 4 Mayer WJ, Kurz S, Wolf A. et al. Dexamethasone implant as an effective treatment option for macular edema due to Irvine-Gass syndrome. J Cataract Refract Surg 2015; 41: 1954-1961
• 5 Kaiser P, Wachtlin J. Wirkung parabulbärer Triamcinoloninjektion bei Makulaödemen bei vitrektomierten Augen und unterschiedlichen Diagnosen. In: Wintertagung der Berlin-Brandenburgischen Augenärztlichen Gesellschaft 2021 German Medical Science GMS Publishing House; 2022: Doc21bbag29
• 6 Shi M, Lu Z, Qin A. et al. A controlled clinical study on efficacy and safety of periocular triamcinolone acetonide injection for treating ocular myasthenia gravis. BMC Ophthalmol 2024; 24: 33
• 7 Li G, Xu D, Hu Z. et al. Embolic retinal and choroidal vascular occlusion after peribulbar triamcinolone injection: A case report. Medicine (Baltimore) 2018; 97: e0467
• 8 Liu OG, Chunming L, Juanjuan W. et al. Central retinal artery occlusion and cerebral infarction following forehead injection with a corticosteroid suspension for vitiligo. Indian J Dermatol Venereol Leprol 2014; 80: 177-179
• 9 Chavala SH, Williamson JF, Postel EA. Embolic central retinal artery occlusion after subcutaneous auricular steroid injection. Lancet 2016; 387: 2235
• 10 Gaur N, Singh P, Chawla R. et al. Triamcinolone emboli leading to central retinal artery occlusion: a multimodal imaging study. BMJ Case Rep 2017; 2017: bcr2016218908
• 11 Edwards AO. Central retinal artery occlusion following forehead injection with a corticosteroid suspension. Pediatr Dermatol 2008; 25: 460-461
• 12 Hayreh SS, Zimmerman MB, Kimura A. et al. Central retinal artery occlusion. Retinal survival time. Exp Eye Res 2004; 78: 723-736
• 13 Varma DD, Cugati S, Lee AW. et al. A review of central retinal artery occlusion: clinical presentation and management. Eye (Lond) 2013; 27: 688-697
• 14 Moshfeghi DM, Lowder CY, Roth DB. et al. Retinal and choroidal vascular occlusion after posterior sub-tenon triamcinolone injection. Am J Ophthalmol 2002; 134: 132-134
• 15 Al-Khersan H, Russell JF, Shi Y. et al. Wide field swept source OCT angiography of multifocal retinal and choroidal occlusions from embolic triamcinolone acetonide. Am J Ophthalmol Case Rep 2020; 18: 100704
• 16 Cohen E, Yatziv Y, Leibovitch I. et al. A case report of ophthalmic artery emboli secondary to Calcium Hydroxylapatite filler injection for nose augmentation- long-term outcome. BMC Ophthalmol 2016; 16: 98
• 17 Szantyr A, Orski M, Marchewka I. et al. Ocular Complications Following Autologous Fat Injections into Facial Area: Case Report of a Recovery from Visual Loss After Ophthalmic Artery Occlusion and a Review of the Literature. Aesthetic Plast Surg 2017; 41: 580-584
• 18 Benzon HT, Chew TL, McCarthy RJ. et al. Comparison of the particle sizes of different steroids and the effect of dilution: a review of the relative neurotoxicities of the steroids. Anesthesiology 2007; 106: 331-338
• 19 Vasavada D, Baskaran P, Ramakrishnan S. Retinal Vascular Occlusion Secondary to Retrobulbar Injection: Case Report and Literature Review. Middle East Afr J Ophthalmol 2017; 24: 57-60