Hemorrhagic occlusive retinal vasculitis after inadvertent intraocular perforation with gentamycin injection



To report a case of hemorrhagic occlusive retinal vasculitis (HORV) secondary to intraocular toxicity due to inadvertent intraocular injection of gentamycin.


A 21-year-old woman was referred to our department because of severe ocular pain and sudden visual loss in her left eye after she received a subconjunctival gentamycin injection for chronic infectious keratitis.


At presentation, best-corrected visual acuity was 20/20 in the right eye and counting fingers in the left eye. Fundus examination showed diffuse intraretinal and perivascular hemorrhages, vascular cuffing, white-centered hemorrhages, and diffuse retinal edema. Fluorescein angiography confirmed occlusive retinal vasculitis with capillary nonperfusion and spectral-domain optical coherence tomography revealed ischemic macular edema. The clinical diagnosis was compatible with HORV secondary to retinal toxicity due to high dose of intraocular gentamycin.


We report a case of HORV secondary to inadvertent subconjunctival gentamycin injection. Ocular perforation and high dose of intravitreal gentamycin administration should be considered as a potential cause of HORV following subconjunctival injection.

Eur J Ophthalmol 2017; 27(2): e50 - e53

Article Type: CASE REPORT



Lea Querques, Elisabetta Miserocchi, Giulio Modorati, Giuseppe Querques, Francesco Bandello

Article History


Financial support: F. Bandello: advisory board member: Allergan, Inc.; Novartis Pharmaceuticals Corporation; Farmila-Thea; Bayer Schering Pharma; Pfizer, Inc.; Alcon, Inc.; Bausch and Lomb; Genentech, Inc.; Alimera Sciences, Inc.; Thrombogenics, Inc.
Conflict of interest: None of the authors has conflict of interest with this submission.

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  • Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy

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