Li Yafeng
Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Case Rep Ophthalmol. 2025 Mar 8;16(1):254-260. doi: 10.1159/000543454. eCollection 2025 Jan-Dec.
Intralesional triamcinolone acetonide is a widely used treatment for scarring skin conditions such as keloid and is known to have retinal vascular complications if administered in the periocular region.
A 32-year-old female experienced a prompt onset transient vision decrease and a delayed onset, slow-resolving vison loss in the right eye (OD) following the last of a series of triamcinolone acetonide corticosteroid (TAC) injections in her right earlobe for a disfiguring keloid. Clinically, she developed a branch retinal arterial occlusion accompanied by features of a central retinal vein occlusion. The TAC particles that entered the retinal circulation are implicated in the thrombo-embolic occlusion of the branch retinal artery and subsequent blockage of the central retinal vein.
This case should alert clinicians that there is always a potential hazard for retinal vascular occlusion when corticosteroid is injected in the region of the head and face because of the rich anastomoses between the external and internal carotid artery circulations.
病灶内注射曲安奈德是治疗瘢痕性皮肤病如瘢痕疙瘩的一种广泛使用的方法,已知在眼周区域注射时会出现视网膜血管并发症。
一名32岁女性在右耳垂注射曲安奈德皮质类固醇(TAC)以治疗毁容性瘢痕疙瘩,在最后一次注射后,右眼(OD)迅速出现短暂视力下降,随后出现延迟发作、恢复缓慢的视力丧失。临床上,她出现了视网膜分支动脉阻塞,并伴有视网膜中央静脉阻塞的特征。进入视网膜循环的TAC颗粒与视网膜分支动脉的血栓栓塞性阻塞以及随后的视网膜中央静脉阻塞有关。
该病例应提醒临床医生,由于颈外动脉和颈内动脉循环之间存在丰富的吻合支,在头面部区域注射皮质类固醇时,始终存在视网膜血管阻塞的潜在风险。