|Year : 2022 | Volume
| Issue : 1 | Page : 331
Intraoperative sub-internal limiting membrane migration of triamcinolone particles
Naresh Babu, Piyush Kohli, Kim Ramasamy
Department of Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
|Date of Web Publication||07-Jan-2022|
Dr. Piyush Kohli
Department of Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Babu N, Kohli P, Ramasamy K. Intraoperative sub-internal limiting membrane migration of triamcinolone particles. Indian J Ophthalmol Case Rep 2022;2:331
|How to cite this URL:|
Babu N, Kohli P, Ramasamy K. Intraoperative sub-internal limiting membrane migration of triamcinolone particles. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Jan 16];2:331. Available from: https://www.ijoreports.in/text.asp?2022/2/1/331/334877
A 50-year-old female with no systemic comorbidities presented with nonresolving vitreous hemorrhage (VH) after a “yoga” session. During vitrectomy, intravitreal triamcinolone was used to ensure posterior hyaloid removal. However, some triamcinolone particles settled inside a premacular cavity under the internal limiting membrane (ILM) [[Figure 1] and Video 1] [Additional file 1].
|Figure 1: Intraoperative images using NGENUITY® 3D Visualization System (Alcon, Forth Worth, Texas, USA) showing (a) triamcinolone particles settled in a premacular cavity under Brilliant Blue G-stained internal limiting membrane (ILM), and margins of the sub-ILM cavity/arcus retinalis (black arrow); (b) opening of the premacular cavity during ILM peeling; (c) remnant triamcinolone particles after ILM was completely peeled; and (d) triamcinolone particles removed from the persistent premacular cavity|
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She was diagnosed to have a breakthrough VH secondary to Valsalva retinopathy. Triamcinolone can enter the persistent premacular cavity after a forceful intravitreal injection, through a preexisting ILM defect. The ILM defect and the premacular cavity form after spontaneous or laser-induced release of sub-ILM hemorrhage.,,, “Arcus retinalis” has been described as a clinical marker for sub-ILM cavity.
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