Ischemic Retinopathy Due to Suspicious Gentamicin Retinal Toxicity after Primary Repair of Scleral Laceration.
10.3341/jkos.2013.54.7.1126
- Author:
Jong Min KIM
1
;
Woon Hyung GHIM
;
Woo Hyung CHO
;
Sung Eun KYUNG
;
Moo Hwan CHANG
Author Information
1. Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea. changmh@dankook.ac.kr
- Publication Type:Case Report
- Keywords:
Gentamicin;
Ischemic retinopathy;
Scleral laceration;
Toxicity
- MeSH:
Anti-Bacterial Agents;
Cefazolin;
Eye;
Fluorescein Angiography;
Gentamicins;
Hemorrhage;
Humans;
Ischemia;
Lacerations;
Muscles;
Papilledema;
Retinal Perforations;
Retinal Vessels;
Retinaldehyde;
Vision, Ocular;
Visual Acuity;
Vitrectomy;
Vitreous Body
- From:Journal of the Korean Ophthalmological Society
2013;54(7):1126-1129
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of ischemic retinopathy due to suspicious gentamicin retinal toxicity after primary repair of a scleral laceration. CASE SUMMARY: A 45-year-old man presented to our department with decreasing vision in his right eye after ocular trauma. Best corrected visual acuity (BCVA) was 0.02 in the right eye and slit lamp examination revealed scleral laceration. Both intravenous and topical antibiotics (10% cefazolin and 2% gentamicin) were immediately administered. On intraoperative examination, a scleral laceration located 5 mm to 11 mm from nasal limbus, prolapsed vitreous body and partial division of medial rectus muscle were observed. After irrigation with gentamincin 0.2% around the wound, primary repair was performed. On postoperative day 3, fundus examination revealed a retinal break, barrier laser was performed. On postoperative day 4, diffuse retinal edema with intraretinal hemorrhage was observed as well as, superonasal ghost vessels. Subsequently, fluorescein angiography showed diffuse leakage of retinal vessels and a nonperfusion area at the periphery, especially on the nasal side. As vitreous opacity became worse, the patient underwent pars plana vitrectomy with endolaser. One month later, vitreous cavity was clearer and best visual acuity was 0.2. CONCLUSIONS: Large doses of intraocular gentamicin ccan cause retinal toxicity. Increased gentamicin application through a scleral laceration may lead to toxic antibiotic levels. When a scleral laceration wound irrigation is performed, precautions are necessary to prevent retinal ischemia associated with gentamicin toxicity.
