Orbital cellulitis complicated by central retinal artery occlusion

• Published in: Ophthalmic plastic and reconstructive surgery Vol. 29; no. 2; pp. e59 - e61
• Main Authors: Proctor, Charles M, Magrath, George N, de Castro, Luis E Fernández, Johnson, John H, Teed, Ronald G
• Format: Journal Article
• Language: English
• Published: United States 01-03-2013
• Subjects: Actinomycetales Infections - diagnosis; Actinomycetales Infections - etiology; Actinomycetales Infections - therapy; Adolescent; Anti-Bacterial Agents - therapeutic use; Arcanobacterium - isolation & purification; Combined Modality Therapy; Decompression, Surgical; Drug Therapy, Combination; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - etiology; Eye Infections, Bacterial - therapy; Fluorescein Angiography; Humans; Intraocular Pressure; Ischemia - diagnosis; Male; Orbital Cellulitis - diagnosis; Orbital Cellulitis - etiology; Orbital Cellulitis - therapy; Retinal Artery Occlusion - complications; Retinal Artery Occlusion - diagnosis; Retinal Vessels - pathology; Vision Disorders - etiology; Visual Acuity
• ISSN: 0740-9303; 1537-2677
• DOI: 10.1097/IOP.0b013e31826b7760

The authors present a case of a 16-year-old boy who sought treatment in Storm Eye Institute for orbital cellulitis complicated by central retinal artery occlusion. He was examined for severe signs of orbital cellulitis, including decreased vision and an afferent pupillary defect. Intravenous antibiotics failed to provide timely improvement, and the patient was surgically managed with endoscopic orbital decompression. An ocular examination under anesthesia revealed retinal ischemia in the affected eye, and fluorescein angiography confirmed the diagnosis of central retinal artery occlusion. The patient's vision improved slightly following resolution of the infection. Central retinal artery occlusion is a rare complication of orbital cellulitis in adults and has yet to be reported in the pediatric population.