Título

INFECTIOUS RETINITIS AND CENTRAL RETINAL ARTERY OCCLUSION SECONDARY TO ORBITAL CELLULITIS

Objetivo

To report a rare case of multiple severe and simultaneous ocular complications of orbital cellulitis (OC): infectious retinitis with retinal necrosis and central retinal artery occlusion (CRAO)

Métodos

case report

Resultados

Female patient, 16 yo, immunocompetent, developed sinusopathy and right eye with proptosis, ophthalmoplegia, chemosis , vitritis, macular retinal necrosis, diffuse vascular attenuation and diffuse retinal pallor compatible with infectious retinitis in the macular region concomitant with CRAO.
Septoplasty and sinusectomy of the right facial sinuses were performed and the culture was positive for Staphylococcus aureus resistant to Ampicillin and Penicillin and the anatomopathological study was compatible with chronic and acute inflammatory process. The patient evolved with worsening of visual acuity and external examination, improvement in vitritis. Antibiotic therapy was maintained for 8 weeks with Cefepime, Oxacillin, Metronidazole and Fluconazole. At the end of treatment and medical discharge, SPL of RE and funduscopy showed regression of macular lesions. On OCT, an extensive area of sensorineural retinal atrophy was observed, corresponding to the area of infection

Discussão e Conclusões

We present a case of infectious retinitis and central retinal artery occlusion secondary to OC associated with sinusopathy and surgically treated by septoplasty and right sinusectomy, and antibiotic therapy. OC can result in serious systemic complications in the case presented, the patient evaluated with empyema, infectious retinitis, CRAO and low visual acuity. Retinal artery occlusion appears to be the most common form of OC-related retinovascular occlusion. Occlusion usually results from compression of the central retinal artery due to increased orbital pressure. We believe that, in the case presented, the occlusion of the ophthalmic artery was the cause of the low visual acuity. Despite early treatment with surgery and antibiotic therapy, the outcome of vision loss could not be avoided

Palavras Chave

ocular complications of orbital cellulitis; infectious retinitis with retinal necrosis and central retinal artery occlusion due to orbital cellulitis

Área

Clínica