Vancomycin
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Haemorrhagic occlusive retinal vasculitis: case report A 9-month-old male infant developed haemorrhagic occlusive retinal vasculitis (HORV) following administration of vancomycin for post-operative prophylaxis after surgery of bilateral lamellar cataract [dosage and duration of treatment to reaction onset not stated]. The infant presented with a white pupil in his left eye. Ophthalmic examination and adjuvant investigations shown a bilateral lamellar cataract that was clinically denser in the left eye than the right eye. He underwent parsplicata lensectomy and anterior vitrectomy. Vein occlusion-like retinopathy with mildly dilated retinal veins was noted in the fundus on routine fundus examination at the first postoperative day. In all retinal quadrants, retinal haemorrhages involving both posterior pole and peripheral retina were observed with few haemorrhages showing a white-centred appearance in an otherwise quiet anterior segment. These retinal findings suggested the possibility of systemic disease-related bilateral retinopathy. He underwent another eye surgery, more evident venous dilatation, more retinal haemorrhages and mild vitreous haemorrhage were noted during the fundus examination conducted after the surgery. The clinical findings and the course of clinical presentation, use of irrigating intraocular solutions of vancomycin 20 µg/mL for both eyes supported the possibility of vancomycin-induced HORV. The infant was treated with betamethasone and dexamethasone and scheduled for regular follow-up visits weekly. A gradual improvement of his retinal condition was seen with a decrease of retinal haemorrhages, improvement of vascular dilatation and disappearance of retinal oedema as well as improved vitreous haemorrhage in the right eye was noted for 11 weeks. Measurement of intraocular pressure, ocular alignment and visual potential were found to be normal when monitored during follow-up visits. El Gendy HA. Vancomycin-associated retinal hemorrhages in pediatric age group: A case report. American Journal of Ophthalmology Case Reports 20: 100880, Dec 2020. 803502111 Available from: URL: http://doi.org/10.1016/j.ajoc.2020.100880
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Reactions 19 Sep 2020 No. 1822
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