Gupta Isha, Moussa Elliott, Motupally Karun, Morris Sharon
Department of Ophthalmology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia.
Department of Radiology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia.
J Surg Case Rep. 2024 May 30;2024(5):rjae339. doi: 10.1093/jscr/rjae339. eCollection 2024 May.
Orbital abscesses are caused by infection within or near the orbit and show obvious signs of pain, proptosis and raised inflammatory markers. Diagnosis is based on clinical features and radiological imaging, and requires early antibiotics and often surgical drainage to save vision. Sub-Tenon's injections of triamcinolone acetonide (TA) have caused localized infections in previous reports, which have responded to therapeutic interventions. Here we report a case where a delayed presentation of an orbital abscess secondary to sub-Tenon's TA for persistent post-operative cystoid macular oedema, without obvious signs of infection, rapidly progressed to cause orbital compartment syndrome. Despite treatment, the patient lost complete vision in the affected eye. This case discusses the rare and unusual cause of abscess formation and a diagnostic dilemma.
眶脓肿由眶内或眶周感染引起，表现出明显的疼痛、眼球突出和炎症指标升高的症状。诊断基于临床特征和影像学检查，需要早期使用抗生素，且常常需要手术引流以挽救视力。既往报道显示，球后注射曲安奈德（TA）可导致局部感染，这些感染对治疗干预有反应。在此，我们报告一例病例，该患者因持续性术后黄斑囊样水肿接受球后TA注射，在无明显感染迹象的情况下，眶脓肿延迟出现，并迅速进展为眶间隔综合征。尽管进行了治疗，患者患眼仍完全失明。本病例讨论了脓肿形成的罕见且不寻常的原因以及诊断难题。
