DIAGNOSIS AND TREATMENT OF AN OPHTHALMIC ARTERY-OCCLUSION DURING AN INTRALESIONAL INJECTION OF CORTICOSTEROID INTO AN EYELID CAPILLARY HEMANGIOMA

PURPOSE: To demonstrate the usefulness of simultaneous indirect ophtha lmoscopy in the diagnosis and treatment of embolization of the ocular circulation during intralesional injection of corticosteroids into cap illary hemangiomas. METHODS: A 4-month-old infant. had an ophthalmic a rtery occlusion during an intralesional injection of corticosteroids i nto a right upper eyelid capillary hemangioma. The injection was disco ntinued immediately and a paracentesis was performed, Fluorescein angi ography was per formed 20 minutes and three weeks after the ophthalmic artery occlusion. RESULTS: Fluorescein angiography after the paracent esis showed delayed retinal and choroidal filling and large areas of r etinal and choroidal ischemia. Three weeks after treatment, the angiog raphic abnormalities had resolved, and the retinal and choroidal circu lations were normal. Twenty-eight months after treatment, the visual a cuity was 20/20 in each eye, CONCLUSION: Ophthalmic artery occlusion c an occur during intralesional injection of corticosteroids into capill ary hemangiomas. Simultaneous indirect ophthalmoscopy allows the surge on to discontinue the injection and provide treatment to allow for the best possible visual outcome after this complication.