RESUMEN
Diabetic retinopathy (DR) is a well-known risk factor in the development of radiation maculopathy (RM). Steroids have been shown to improve the vision and reduce the macular thickness in patients with RM. This observational case report highlights altered course of DR after a course of radiotherapy for orbital lymphoma, after a single dose of intravitreal dexamethasone implant showed a dramatic revascularization of the ischemic macula, with a significant reduction in the size of ischemic area. This appears to be the first case in literature corroborating the favorable effect on steroids on retinal vasculature, seen angiographically.
RESUMEN
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 infarction 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 significant decrease in visual acuity. Fluorescein angiogram showed an enlargement of the foveal avasacular zone, although optical 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. CONCLUSIONS: Intravitreal anti-vascular endothelial growth factor injection as well as intravitreal triamcinolone injection can cause macular ischemia which should be considered with the adopted treatment regimen for patients with ischemic risk factors.