To describe a syndrome of hemorrhagic occlusive retinal vasculitis (HORV) that developed after seemingly uncomplicated cataract surgery.
Retrospective case series.
Eleven eyes of 6 patients from 6 different institutions.
Cases were identified after discussion among retina specialists. The findings on presentation, clinical course, and outcome of a series of 7 eyes of 4 patients were compared with a previous report of 4 eyes of 2 patients, and data from both series were combined for a comprehensive analysis.
Historical data, examination findings, imaging results, systemic evaluation findings, treatment regimens, and visual outcomes.
Eleven eyes of 6 patients underwent otherwise uncomplicated cataract surgery, receiving viscoelastic and prophylactic intracameral vancomycin during the procedure. Despite good initial vision on postoperative day 1, between 1 to 14 days after surgery, all eyes demonstrated painless vision loss resulting from HORV. Extensive ocular and systemic evaluations were unrevealing in all patients. All patients were treated with aggressive systemic and topical corticosteroids. Additional treatments included systemic antiviral medication in 4 patients, intravitreal antibiotics in 4 eyes, and pars plana vitrectomy in 4 eyes. Skin testing for vancomycin sensitivity showed negative results in 3 patients and was not performed in the others. Neovascular glaucoma developed in 7 eyes, and all eyes received intravitreal anti-vascular endothelial growth factor (VEGF) injection, panretinal photocoagulation, or both for retinal ischemia. Final visual acuity was less than 20/100 in 8 of 11 eyes.
Postoperative HORV is an exceedingly rare and potentially devastating condition that can occur after otherwise uncomplicated cataract surgery. Although the precise cause remains unknown, this disease may represent a delayed immune reaction similar to vancomycin-induced leukocytoclastic vasculitis. Despite treatment with high-dose corticosteroids, antiviral medication, and early vitrectomy in many patients, visual outcomes typically were poor in this series. Early intervention with intravitreal anti-VEGF medication and panretinal photocoagulation may help to prevent additional vision loss resulting from neovascular glaucoma.
Pharmacology, Toxicology and Pharmaceutical Science
1
2%
Biochemistry, Genetics and Molecular Biology
1
2%
Nursing and Health Professions
1
2%
Computer Science
1
2%
Other
2
3%
Unknown
28
44%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 June 2023.
All research outputs
#2,074,122
of 25,998,826 outputs
Outputs from Ophthalmology
#573
of 7,002 outputs
Outputs of similar age
#25,903
of 282,350 outputs
Outputs of similar age from Ophthalmology
#10
of 94 outputs
Altmetric has tracked 25,998,826 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,002 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.6. This one has done particularly well, scoring higher than 91% of its peers.
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We're also able to compare this research output to 94 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.
