Importance of careful clinical examination and multimodal imaging before injecting intravitreal steroid

Abstract

Intravitreal injections have now become the most preferred treatment for retinal vascular diseases. Intravitreal steroids are associated with complications such as cataracts, glaucoma, and central serous chorioretinopathy (CSCR). We report a case who developed CSCR after a single injection of intravitreal triamcinolone, given for the treatment of cystoid macular edema (CME) secondary to branch retinal venous occlusion (BRVO). On careful retrospective examination, we found that pachychoroid and a pigment epithelial detachment was present even before the injection was given. Four months postinjection, there was a recurrence of CME due to BRVO while there was no sign of CSCR. We emphasize on the importance of a careful clinical examination and appropriate interpretation of multimodal imaging before injecting intravitreal steroids.

Keywords

• central serous chorioretinopathy
• intravitreal triamcinolone acetonide
• mineralocorticoid-receptor
• pigment epithelial detachment
• toxicity