Macular Infarction Following Intravitreal Triamcinolone Injection for Treatment of Central Retinal Vein Occlusion

Abstract

PurposeTo report a case of macular infarction following intravitreal triamcinolone injection for treatment of central retinal vein occlusionMethodsA 75‐year‐old man visited our clinic for visual disturbance in his left eye, who had diagnosed with macular infarction in his right eye. The patient's best‐corrected visual acuity was 0.6 in his left eye. His medical history included type 2 diabetes, alcoholic liver cirrhosis, hepatocellular carcinoma. After fundus examination, the patient was diagnosed with central vein occlusion with macular edema, intravitreal triamcinolone was administered in an attempt to reduce edema.ResultsWithin 1 week of treatment with intravitreal injection, the patient noted a significant decrease in visual acuity. Flurorescein angiogram demonstrated an enlargement of the foveal avascular zone following intravitreal triamcinolone, although optical coherence tomography (OCT) showed a decresed maculr edema. Despite normalization of macular thickness on OCT and cessation of leakage on angiography, visual acuity remained at the same level until 2 month of follow‐up.ConclusionsNot only intravitreal anti‐VEGF injection, but also intravitreal triamcinolone injection can cause macular ischemia. This must be taken into consideration when the treatment regime is adopted for use in patients with ischemic risk factors.