Linear subcutaneous fat atrophy after corticosteroid injection of periocular hemangiomas

Two children developed evidence of subcutaneous fat atrophy after corticosteroid injection of periocular hemangiomas. The atrophy appeared at the site of injection and followed the expected course of lymphatic channels to the vicinity of regional lymph nodes.     

Orbital rim fat atrophy after repository periocular corticosteroid injection.

A 29-year-old white woman with acute recurrent nongranulomatous iridocyclitis of undetermined cause was treated with a retrobulbar injection of depocorticosteroid (Kenalog) through the inferior eyelid. This resulted in rapid clearing of the uveitis, but she developed subcutaneous and inferior orbital fat atrophy. This atrophy persisted during the 1 1/2 years of observation.     

平阳霉素局部注射治疗眼部血管瘤

目的探讨平阳霉素治疗眼部血管瘤的疗效、作用机理及治疗时机。方法平阳霉素10mg（粉剂）溶于10g·L-1利多卡因或生理盐水3～5ml中，皮试针头直接刺入瘤体内注药，以注药后瘤体变苍白肿胀为宜。对瘤体较大或多发者可分次注药，每次间隔7～10d。结果治疗19例，特效8例，显效11例，治愈率100％。结论平阳霉素可迅速抑制细胞内皮增生，使血管闭塞萎缩，血液供应不足，从而使血管瘤消退。治疗过程中未发现任何不良反应及副作用。     

准分子激光屈光性角膜切削术后皮质类固醇性高眼压和青光眼的临床分析

目的探讨准分子激光屈光性角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ,ＰＲＫ）后皮质类固醇性高眼压（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｏｃｕｌａｒｈｙｐｅｒｔｅｎｓｉｏｎ）及皮质类固醇性青光眼（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｇｌａｕｃｏｍａ）的发生率、临床特征及治疗效果。方法用美国ＶＩＳＸ２０／２０准分子激光系统,对ＰＲＫ术后１５９０只眼滴用皮质类固醇（０．１％氟米龙）眼液４～６个月,分别于术后１个月、３个月、６个月、１年及２年观察眼压变化,对于高眼压者给予治疗。结果本组１５９０只眼中４３只眼发生皮质类固醇性高眼压或皮质类固醇性青光眼,发生率为２．７％。经停用皮质类固醇眼液,滴用０．５％噻吗心安（或０．５％盐酸左布诺洛尔）眼液,必要时口服醋氮酰胺或行小梁切除术等,眼压均降至正常。结论ＰＲＫ术后滴用皮质类固醇眼液可发生皮质类固醇性高眼压及皮质类固醇性青光眼,个别患者视功能损害严重。对此,应停用皮质类固醇眼液,滴用β受体阻滞剂眼液或和口服碳酸酐酶抑制剂等;对视功能严重损害、停用降眼压药后眼压仍较高的患眼应行小梁切除术,经治疗眼压均可降至正常。     

Normalisation of refractive error after steroid injection for adnexal haemangiomas.

A longitudinal study of 27 patients with infantile haemangiomas is reported. It confirmed the efficacy of local steroid injection as a method of treatment; 81.5% of patients showed a marked improvement, with the lesion reducing to 25% or less of its original size. Involution was most marked in the first two weeks but continued for up to four months after injection. Amblyopia was present in 43% of children and was usually the result of induced refractive error rather than obstruction of the visual axis or strabismus. Anisometropia was found in 68% of children, with a high incidence of asymmetric astigmatism on the side of the haemangioma. Following local steroid injection a marked reduction in astigmatism was noted in 53.8% of children, a lesser reduction in 15.4%, and no reduction in 30.8%. Successful treatment of the haemangioma, therefore, may not remove the risk of amblyopia, and regular refraction and visual assessment remain mandatory.     

准分子激光屈光性角膜切削术后皮质类固醇性高眼压和青光眼的 …

目的 探讨准分子激光屈光性角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ,ＰＲＫ）后皮质类固醇性高眼压（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｏｃｕｌａｒｈｙｐｅｒｔｅｎｓｉｏｎ）及皮质类固醇性青光眼（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｇｌａｕｃｏｍａ）的发生率,临床特征及治疗效果。方法 用美国ＶＩＳＸ２０／２０准分子激光系统,对ＰＲＫ术后１５９０只眼滴用皮质类固醇（０．１％氟米龙）眼液４－６个     

Central serous chorioretinopathy after epidural corticosteroid injection

PURPOSE: To report three patients who developed central serous chorioretinopathy after epidural corticosteroid injection for treatment of back pain. DESIGN: Interventional case series. METHODS: Three men, aged 73, 52, and 73 years, presented with bilateral central serous chorioretinopathy after corticosteroid injection in the epidural space for treatment of back pain. In all three cases, we did not initially elicit the history of corticosteroid use. RESULTS: Two of the three patients, aged 52 and 73 years, had diffuse retinal pigment epitheliopathy and one, aged 73 years, had classic central serous chorioretinopathy. Two patients had a spontaneous resolution of the subretinal fluid in both eyes. One patient had laser photocoagulation in both eyes but continued to have diffuse leakage in one eye. CONCLUSIONS: A careful history to determine corticosteroid use, including possible intrajoint and epidural injection, should be performed in older people with serous detachment of the macula, particularly when bilateral.     

Lower eyelid herniation of orbital fat may complicate periocular corticosteroid injection

PURPOSE: To report a case of lower eyelid herniation of orbital fat occurring after periocular corticosteroid injection. DESIGN: Interventional case report. METHODS: A 44-year-old man with asymmetrical pars planitis complicated by right cystoid macular edema was treated with multiple right orbital floor injections of triamcinolone through the lower eyelid. RESULTS: Right lower eyelid orbital fat herniation occurred during the course of the treatment. CONCLUSION: A herniation of orbital fat may complicate the injection of corticosteroid through the lower eyelid.     

Adrenal suppression after corticosteroid injection of periocular hemangiomas

Two infants with symptomatic periocular hemangiomas received 1-ml intralesional injections of a 50:50 mixture of triamcinolone acetonide (40 mg/ml) and betamethasone (8 mg/ml). Both developed adrenal suppression as evidenced by the immediate depression of their serum cortisol and adrenocorticotrophic hormone levels. One patient remained adrenal suppressed for five months and, concurrently, her growth rate and weight dropped from normal to below the fifth percentile. Adrenal suppression should be added to the growing list of complications caused by the corticosteroid injection of periocular hemangiomas.     

Posterior ciliary-artery occlusion after subcutaneous silicone-oil injection

Visual loss occurred after subcutaneous silicone-oil injection for cosmetic purposes. To our knowledge, this is the first instance of amaurosis caused by a subcutaneous foreign-material injection that spared the central retinal artery and affected portions of the posterior ciliary-artery distribution, including a probable cilioretinal artery. The visual-field defects produced allow a rare opportunity to view the distribution of the human posterior ciliary-artery circulation by means of this in vivo pathologic embolic process. The facial arterial anatomy pertinent to ocular embolism is also discussed.