RESUMO
PURPOSE: To describe a case of a penetrating ocular trauma and plastic intraocular foreign body (IOFB), undetected on preoperative imaging. OBSERVATIONS: We present the findings of a 40-year-old male who sustained an open globe injury and IOFB composed of plastic following crossbow-related trauma. Preoperative detection of the IOFB was unsuccessful on clinical exam, computed tomography (CT) and ultrasonography. During extraction of the traumatic cataract, an intralenticular IOFB was discovered and removed through an enlarged limbal incision. Postoperative review revealed that a fragmented plastic "nock", from the crossbow arrow bolt, was the likely IOFB source. The bolt was produced by injection molding which may lead to trapped gas within the plastic, causing radiolucency on CT. CONCLUSIONS AND IMPORTANCE: Radiolucent plastic warrants consideration on the differential diagnosis when intraocular gas is noted on computed tomography following penetrating ocular trauma. Multimodal imaging should be considered if IOFB is suspected and not detected by CT.
RESUMO
We present 2 cases of iatrogenic retinal penetration from intravitreal (IVT) injections in a retrospective noncomparative case series of 2 patients. The first patient, an 81-year-old Caucasian male, developed dense vitreous hemorrhage soon after receiving an IVT bevacizumab injection for macular edema from central retinal vein occlusion. A 25-g vitrectomy 1 week later showed a retinal hole surrounded by fresh hemorrhages in the same quadrant as the IVT injection. The second patient, an 87-years-old male, developed a retinal detachment after 28 injections of anti-VEGF medications for neovascular AMD. A peripheral round hole was observed during vitrectomy without any lattice degeneration in the same quadrant as prior IVT injections. Both eyes were pseudophakic, had normal axial lengths, and received injections without measuring the injection site. Retinal penetration from IVT injections can result in serious sight-threatening complications. Measuring the injection site from the limbus should be part of safe IVT injection technique.