Paracentral acute middle maculopathy and ocular ischemic syndrome after intranasal steroid injection: a case report and review of the literature.

Abstract

To describe a case of paracentral acute middle maculopathy and ocular ischemic syndrome after intranasal steroid injection. Case report. Following an intranasal steroid injection, the patient experienced an episode of amaurosis fugax in her right eye lasting several minutes. Afterwards, her visual acuity returned to baseline, but she noted a persistent central scotoma. Optical coherence tomography (OCT) demonstrated paracentral acute middle maculopathy and fluorescein angiography showed staining and leakage to peripheral vessels concerning for diffuse ischemia. Steroid injections to the face and nasopharynx may result in ischemic and vaso-occlusive events in the retina. Both ophthalmologists and other physicians performing these procedures need to be aware of this potential adverse outcome.