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Abstract
Purpose
To report a case of macular infarction following intravitreal triamcinolone injection for treatment of central retinal vein occlusion.
Case summary
A 75-year-old male visited our clinic for visual disturbance in his left eye and was diagnosed with macular in-farction in his right eye. His medical history included type 2 diabetes, alcoholic liver cirrhosis, and hepatocellular carcinoma. After fundus examination, the patient was diagnosed with central vein occlusion with macular edema and intravitreal triamcinolone was administered to reduce edema. Within 1 week of treatment with the intravitreal injection, the patient experienced a sig-nificant decrease in visual acuity. Fluorescein angiogram showed an enlargement of the foveal avasacular zone, although opti-cal coherence tomography (OCT) showed a decreased macular edema. Despite normalization of macular thickness on OCT and cessation of leakage on angiography, visual acuity remained at the same level during 2 months of follow-up.
References
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Figure 1.
At initial visit, fundus photograph of left eye. (A) Dilated and tortuous retinal veins, flame-shaped retinal hem-orrhage and papilledema. (B, C) Optical coherence tomog-raphy demonstrates moderate macular edema. S = superior; N = nasal; T = temporal; I = inferior.
Figure 2.
Fluorescein angiography of right eye. (A, B) Early and late phase fluorescein angiography of right eye shows irregular en-largement of the foveal avascular zone temporally.
Figure 3.
A week after intravitreal injection of triamcinolone, the fundus photograph. (A) Diffuse whitening of the perimacular reti-na and attenuated retinal vasculature. (B) 8 weeks after intravitreal injection, persistent whitening of the posterior pole and newly developed disc hemorrhage was observed on fundus photograph. (C, D) However, optical coherence tomography shows decreased macular edema. S = superior; N = nasal; T = temporal; I = inferior.
Figure 4.
A week after intravitreal injection of triamcinolone, Fluorescein angiography. (A, B) A week after intravitreal injection of triamcinolone, the early phase of fluorescein angiography shows marked capillary non-perfusion of the macula. (C, D) The late phase of fluorescein andiography reveals persistent central macular nonperfusion with irregular margin.
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