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CASE REPORT
Triamcinolone emboli leading to central retinal artery occlusion: a multimodal imaging study
  1. Nripen Gaur,
  2. Pallavi Singh,
  3. Rohan Chawla,
  4. Brijesh Takkar
  1. Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India
  1. Correspondence to Dr Rohan Chawla, dr.rohanrpc{at}gmail.com

Summary

A 19-year-old man presented with unilateral sudden onset vision loss following an intra-articular triamcinolone injection in the right temporomandibular joint. At fundus examination emboli of triamcinolone were visible in multiple retinal arteries. Choroidal ischaemia and occlusion of the central retinal artery and its branches were documented at fluorescein angiography. Optical coherence tomography revealed significant thickening of the inner retinal layers. Optical coherence tomography angiography clearly demonstrated an abrupt cut-off of flow in a vessel below the optic disc. Lack of perfusion of the superficial and deep retinal plexuses beyond the areas of embolisation and at the posterior pole was also appreciated. The visual outcome was poor despite treatment.

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Footnotes

  • Contributors All authors have participated in the intellectual content, conception and design of this work, as well as the writing of the manuscript. Each author confirms they meet the criteria for authorship as established by the ICMJE. NG was involved in acquisition of data, manuscript preparation and editing. PS was involved in acquisition of data and manuscript preparation. RC was involved in interpretation of data, conception and design, manuscript editing. BT was involved in interpretation of data and manuscript editing.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.