Combined central retinal vein, central retinal artery and cilioretinal artery occlusion with ischemic macular hole secondary to severe orbital cellulitis after black fly bite

Pseudomonas aeruginosa orbital cellulitis complicated by ophthalmic artery occlusion in an immunocompetent patient: A case report

Introduction

We described a case of a pseudomonas aeruginosa subperiosteal abscess in a healthy adult, complicated by ophthalmic artery occlusion.

Case presentation

A 41-year-old woman presented with the chief complaint of a severe painful left eyelid. The visual acuity was limited to light perception. Fundus examiantion showed diffuse retinal edema, papillary swelling and whitened retinal vessels without cherry-red spot. Multimodal imaging confirmed the diagnosis of ophthalmic artery occlusion. Computed tomography study was performed and objectified a pansinusitis complicated by left orbital cellulitis and a 7.4mm × 29.8 mm subperiosteal abscess (SPA). In addition to intravenous antibiotics, surgical drainage of the SPA was performed. The bacterial culture of the abscess has shown growth of Pseudomonas aeruginosa and laboratories studies did not find any cause of immunodeficiency. Although medical and surgical treatment, the retinal damage was irreversible with visual acuity limited to light perception.

Clinical discussion

The developing of a subperiosteal abscess (SPA) of the orbit is a serious complication that arises usually from bacterial sinusitis and can lead to sight threatening complications. Pseudomonas aeruginosa is not common in healthy adults. An early diagnosis and an adequate treatment are important for the visual prognosis.

Conclusion

Orbital cellulitis should be diagnosed and treated promptly, even in healthy people, to improve visual prognosis.

A Periorbital Abscess with Combined Retinal Artery Occlusion and Retinal Vein Occlusion: A Case Report

Patient: Female, 17-year-old

Final Diagnosis: Periorbital abscess • retinal artery and vein occlusion

Symptoms: Blindness • nasal congestion • pain the eye • proptosis

Medication: —

Clinical Procedure: Drainage • endoscopic sinus surgery

Specialty: Otolaryngology

Hemicentral Retinal Artery Occlusion: A Rare Complication of Orbital Cellulitis

A 14-year-old boy presented with acute vision loss and swelling of the right eye. An anterior segment examination revealed a relative afferent pupillary defect, severe proptosis, and ophthalmoplegia in his right eye. The fundus examination revealed inferior hemicentral retinal artery occlusion. Although the authors proceeded with systemic medical treatment, the findings did not improve. An endoscopic orbital decompression was performed. With both medical and surgical treatment, the orbital cellulitis resolved and the patient's visual acuity improved. [J Pediatr Ophthalmol Strabismus. 2020;57:e51-e55.].