Toxic Posterior Segment Syndrome Presenting as Occlusive Retinal Vasculitis Following Vitreoretinal Surgery

Sahoo, Niroj Kumar; Behera, Shashwat; Narayanan, Raja; Chhablani, Jay

doi:10.4103/joco.joco_42_20

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…The possible mechanisms of silicone oil induced toxicity include a direct immunogenicity to the components such as ionic compounds, cleavable fluoride present in silicone oil, direct toxicity of silicone oil, or emulsification of silicone oil. 10 Another case series reported by Sahoo et al, 11 reported toxic posterior segment syndrome presenting as occlusive retinal vasculitis due to silicone oil tamponade.…”

Section: Discussionmentioning

confidence: 97%

Silicone oil tamponade induced vasculitis- a rare manifestation of toxic posterior segment syndrome

Simakurthy,

Kumar,

Jain

et al. 2023

European Journal of Ophthalmology

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Aim To report silicone oil tamponade induced vasculitis in the early post operative period - a rare manifestation of ‘Toxic Posterior Segment Syndrome’ after pars plana vitrectomy for rhegmatogenous retinal detachment. Case description A 50-year-old gentleman presented with vasculitis after a pars plana vitrectomy with silicone oil tamponade on the first post-operative day. He was started on oral steroids (1 mg/ kg) tapered sequentially every week. All signs of vasculitis resolved over a period of one month after which the silicone oil was removed. The patient maintained a visual acuity of 20/90 even after 3 months. There was no recurrence of vasculitis observed thereafter. Conclusion Silicone oil induced vasculitis is a rarely described entity, especially as a manifestation of toxic posterior segment syndrome. This differential must be kept in mind even on the first post-operative day in cases where silicone oil has been used for tamponade.

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Section: Discussionmentioning

confidence: 97%

Silicone oil tamponade induced vasculitis- a rare manifestation of toxic posterior segment syndrome

Simakurthy,

Kumar,

Jain

et al. 2023

European Journal of Ophthalmology

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“…[ 5 ] In literature, it is shown to be developed both after posterior segment surgeries with signs and symptoms of retinal vasculitis and a dropless cataract surgery. [ 5 - 7 ]…”

Section: Discussionmentioning

confidence: 99%

Unusual Inflammatory Clinical Presentation After Cataract Surgery and that Thought-provoking Question: Is this Infection or Toxic Anterior Segment Syndrome?

Kaplan,

Tas,

Selver

2022

Middle East African Journal of Ophthalmology

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PURPOSE: Toxic anterior segment syndrome (TASS) is a noninfectious anterior chamber reaction caused by ocular surgeries. It usually develops within the first 12–48 h after surgery. In case of clinical suspicion of TASS, endophthalmitis as a devastating disease should always be excluded. However, the fact that TASS and endophthalmitis can look the same, but the treatment for each is different. Therefore, distinguishing between the two conditions is an important factor in coping with both diseases. It was aimed to describe the features and clinical management that are considered when distinguishing the cause of unexpected inflammatory response after cataract surgery. METHODS: A retrospective review of medical records of 13 patients who developed TASS in our clinic at Ege University Ophthalmology Department on three different days between July 2022 and December 2022 were included in this study. Anterior segment photographs of those 13 patients and the records of ophthalmological examinations of those patients, including best-corrected visual acuity (BCVA), ocular pressure, biomicroscopic, and fundoscopic examination, were collected. Medical data were evaluated retrospectively. RESULTS: The mean time to onset of clinical symptoms was 27.6 h. The main complaint was pain in nine patients. The primary symptom in the remainder of the patients was blurred vision. Severe hypopyon was seen in 5 cases. Despite the presence of pain and hypopyon, patients who were treated with topical steroids were closely followed up (every 2 h) because they were consecutive patients and had relatively acute onset complaints. Inflammation was regressed after an average of 4 h. No factor causing TASS was found. The BCVA was at the minimum level of 8/10 on the 5th day of surgery. CONCLUSION: When distinguishing TASS from endophthalmitis, severe pain, relatively late onset, hyperemia, and the presence of severe hypopyon usually lead ophthalmologists to the clinical diagnosis of endophthalmitis. However, in this study, most of the patients diagnosed with TASS had severe pain, a significant portion of them had hypopyon, and the onset of the symptoms was relatively late. Close follow-up immediately after suspicion plays a vital role in clinical diagnosis and management accordingly.

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Exogenous Endophthalmitis

Fabiani

Agarwal

Dogra

et al. 2022

Ocular Immunology and Inflammation

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Toxic Posterior Segment Syndrome Presenting as Occlusive Retinal Vasculitis Following Vitreoretinal Surgery

Cited by 8 publications

References 11 publications

Silicone oil tamponade induced vasculitis- a rare manifestation of toxic posterior segment syndrome

Silicone oil tamponade induced vasculitis- a rare manifestation of toxic posterior segment syndrome

Unusual Inflammatory Clinical Presentation After Cataract Surgery and that Thought-provoking Question: Is this Infection or Toxic Anterior Segment Syndrome?

Exogenous Endophthalmitis

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