Sanchez George, Srivatsan Sudarshan, Kim Hee Joon, Kersten Robert C
Department of Oculoplastic and Facial Plastic Surgery, John A. Moran Eye Center, University of Utah Health, Salt Lake City, U.S.A.
Ophthalmic Plast Reconstr Surg. 2025;41(1):e27-e30. doi: 10.1097/IOP.0000000000002804. Epub 2024 Sep 27.
The risk of blindness associated with periocular and facial injections is well documented. Previous cases describing vision loss following a recent periocular or facial injection have emphasized the importance of facial "danger zones." To date, the literature suggests that nearly half of all cases of central retinal artery occlusion in the setting of a recent periocular or facial injection involve an injection in or around the nose. Here, the authors report the second known case of central retinal artery occlusion following a triamcinolone injection to the lacrimal gland. A 30-year-old female with a diagnosis of IgG4-related disease underwent lacrimal gland debulking with an intralesional steroid injection. She noted OD vision loss immediately after surgery, with posterior segment examination demonstrating retinal whitening with a cherry-red spot and intra-arterial yellow-white plaques. This case serves as a reminder to clinicians regarding the risk of iatrogenic embolism following triamcinolone injections around the face with special attention drawn to the lacrimal gland.
与眼周和面部注射相关的失明风险已有充分记录。先前描述近期眼周或面部注射后视力丧失的病例强调了面部“危险区域”的重要性。迄今为止，文献表明，在近期眼周或面部注射情况下发生的所有视网膜中央动脉阻塞病例中，近一半涉及在鼻子或其周围进行的注射。在此，作者报告了第二例已知的泪腺注射曲安奈德后发生视网膜中央动脉阻塞的病例。一名诊断为IgG4相关疾病的30岁女性接受了泪腺减容术并进行了病灶内类固醇注射。她在手术后立即注意到右眼视力丧失，后部检查显示视网膜变白，有樱桃红斑和动脉内黄白色斑块。该病例提醒临床医生注意面部周围注射曲安奈德后发生医源性栓塞的风险，尤其要关注泪腺。
