Retinal necrosis secondary to inadvertent intravitreal methylprednisolone acetate (depo-medrol) injection during pars plana vitrectomy.

Overview

PURPOSE: Methylprednisolone acetate (Depo-Medrol, Pfizer, New York) is a depot corticosteroid that is commonly injected periorbitally to treat various ophthalmologic conditions. Accidental intravitreal injections secondary to globe perforations have resulted in rapid retinal toxicity. To their knowledge, the authors report the first case of inadvertent intravitreal methylprednisolone acetate injection during pars plana vitrectomy. METHOD: Report of a case of inadvertent intravitreal injection of methylprednisolone acetate, mistaken as triamcinolone acetonide, during repeated retinal detachment repair. RESULTS: The affected eye had loss of vision, afferent pupillary defect, optic nerve atrophy, retinal necrosis, retinal vascular damage, and recurrent retinal detachment. DISCUSSION: Methylprednisolone acetate administered during vitrectomy causes severe retinal toxicity and complicates retinal detachment repair. It is important to use measures to avoid erroneous intravitreal injections during vitrectomy.