ABSTRACT
We report a case of a choroidal neovascular membrane (CNVM) following ocular penetration during peribulbar anesthesia in a 55-year-old male patient. A combination of photodynamic therapy with intravitreal bevacizumab led to resolution of the persistent CNVM.
Subject(s)
Anesthesia, Local/adverse effects , Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Choroid/injuries , Choroidal Neovascularization/drug therapy , Eye Injuries, Penetrating/drug therapy , Photochemotherapy , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/etiology , Combined Modality Therapy , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/etiology , Fluorescein Angiography , Humans , Injections , Male , Middle Aged , Needlestick Injuries/diagnosis , Needlestick Injuries/etiology , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity , Vitreous BodyABSTRACT
BACKGROUND: Though a needleless jet injection device (NJI device) has advantages over a conventional needle attached syringe for injecting anesthetics, safety of using it for lid surgery is not proved. We report a case of posterior segment injury suspected caused by a NJI device. METHODS: A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device. RESULTS: Vitreous and subretinal hemorrhage was found associated with retinal edema adjacent to the optic disc of the right eye and around the inferior temporal arcade of the left eye. Fluorescein angiography revealed choroidal rupture in the both eyes. By 2 months, although the hemorrhage resolved, subretinal fibrosis and chorioretinal atrophy developed. Her vision decreased to 20/60 in the right eye and 20/40 in the left eye. CONCLUSION: The energy generated by the NJI device seemed to have reached the eyeballs to cause the blunt-typed posterior segment injuries. As choroidal rupture may result in a permanent visual loss, the risks associated the off-labeled use of the device for lid surgeries should be awakened.
Subject(s)
Anesthesia, Local/instrumentation , Choroid/injuries , Eye Injuries/etiology , Injections, Jet/adverse effects , Wounds, Nonpenetrating/etiology , Anesthetics, Local/administration & dosage , Eye Injuries/diagnosis , Eyelids/drug effects , Female , Fluorescein Angiography , Humans , Middle Aged , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/etiology , Rupture , Vision Disorders/diagnosis , Vision Disorders/etiology , Vitreous Hemorrhage/diagnosis , Vitreous Hemorrhage/etiology , Wounds, Nonpenetrating/diagnosisSubject(s)
Anesthesia, Local/adverse effects , Anesthetics, Local/administration & dosage , Eye Injuries, Penetrating/etiology , Needlestick Injuries/etiology , Retina/injuries , Bupivacaine/administration & dosage , Choroid/injuries , Drug Combinations , Eye Injuries, Penetrating/pathology , Female , Fundus Oculi , Humans , Intraocular Pressure , Lens Implantation, Intraocular , Mepivacaine/administration & dosage , Middle Aged , Needlestick Injuries/pathology , Orbit , Phacoemulsification , Retina/pathology , Retinal Hemorrhage/etiology , Retinal Hemorrhage/pathology , Sclera/injuries , Visual AcuityABSTRACT
A case of uniocular visual loss secondary to trauma sustained during a competitive karate bout is reported.