PARACENTRAL ACUTE MIDDLE MACULOPATHY AND OCULAR ISCHEMIC SYNDROME AFTER INTRANASAL STEROID INJECTION: A CASE REPORT AND REVIEW OF THE LITERATURE

PURPOSE: To describe a case of paracentral acute middle maculopathy and ocular ischemic syndrome after intranasal steroid injection. METHODS: Case report. RESULTS: Following an intranasal steroid injection, the patient experienced an episode of amaurosis fugax in her right eye lasting several minutes. Afterward, her visual acuity returned to baseline, but she noted a persistent central scotoma. Optical coherence tomography demonstrated paracentral acute middle maculopathy and fluorescein angiography showed staining and leakage to peripheral vessels concerning for diffuse ischemia. CONCLUSION: Steroid injections to the face and nasopharynx may result in ischemic and vaso-occlusive events in the retina. Ophthalmologists and other physicians performing these procedures need to be aware of this potential adverse outcome.