Inadvertent Globe Penetration and Subretinal injection of Botulinum Toxin in an Oculocutaneous Albinism Patient.

Abstract

To present a case of localized retinal detachment and mild vitreous hemorrhage in a patient with oculocutaneous albinism following accidental intraocular injection of botulinum toxin A. Botulinum toxin A injection were administered to a 5-year old oculocutaneous albinism patient with esotropia, and resulted in an ocular penetration. Dilated fundus examination indicated a nasal retinal tear causing a mild vitreous hemorrhage and a localized retinal detachment. No treatment was required for the retinal detachment and we observed the patient at regular intervals. On Day 1, the detachment resolved spontaneously without sequelae. On follow up, scarring at the lesion site was detected at one month after the incidence and the patient's vision was stable. In this instance, Observation was sufficient for our patient with complete resolution of retinal detachment and no long-term complication. Botulinum toxin A did not appear toxic to intraocular tissues. However, intramuscular botulinum toxin A injection should be administered carefully. Oculocutaneous albinism did not seem to affect the final outcome in our case.