ACCIDENTAL SUBRETINAL INJECTION OF TRIAMCINOLONE ACETONIDE

Approximately one-third of the contents of a I-mi, 40-mg ampule of tri amcinolone acetonide was accidentally injected into the subretinal spa ce of the left eye of a 30-year-old man with chronic uveitis. The manu facturer provided a list of the contents of the ampule. A large, white subretinal mass was seen in the superotemporal quadrant. In subsequen t days, the medication was seen to migrate inferiorly. Visual acuity i n the left eye was 20/400. Subretinal hemorrhage and mild atrophy of t he retinal pigment epithelium and choroid were observed superotemporal ly. Visual acuity returned to 20/100 (preinjection level) in 1 week, F our months postinjection, the superotemporal atrophy was more severe; the inferotemporal medication was minimally visible without producing significant chorioretinal atrophy. The visual acuity remained at 20/10 0 until the patient underwent cataract extraction and intraocular lens implantation; his vision then improved to 20/40. Steroids, when not a ccompanied by harmful vehicle substances, may be well tolerated by ocu lar tissues.