TY - JOUR
T1 - Sudden occurrence of Roth spots and retinal hemorrhages following endoscopic adhesiolysis
T2 - An SD-OCT evaluation
AU - Dell’Arti, Laura
AU - Barteselli, Giulio
AU - Pinna, Valentina
AU - Invernizzi, Alessandro
AU - Mapelli, Chiara
AU - Viola, Francesco
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Purpose: To document the occurrence of Roth spots and retinal hemorrhages by spectral-domain optical coherence tomography (SD-OCT) following endoscopic adhesiolysis for failed back surgery syndrome. Methods: Case report. Results: A 47-year-old patient noted progressive and bilateral visual loss immediately after epidural endoscopy and endoscopic adhesiolysis. Funduscopic examination showed multiple Roth spots and retinal hemorrhages at the posterior pole and the retinal midperiphery in both eyes. Spectral-domain optical coherence tomography demonstrated that Roth spots involved the inner retina, while dot hemorrhages involved the outer retina. Most retinal hemorrhages and Roth spots resolved over 6 weeks, with complete functional recovery in both eyes. However, SD-OCT revealed multiple areas of disruption of the outer retinal layers in the left eye. Conclusions: Roth spots and retinal hemorrhages can occur after endoscopic spinal surgery. Although hemorrhages resolve quickly over few weeks, SD-OCT can demonstrate that retinal damage might persist, especially in the outer retina. This finding may explain cases of incomplete recovery of visual function after complicated endoscopic adhesiolysis.
AB - Purpose: To document the occurrence of Roth spots and retinal hemorrhages by spectral-domain optical coherence tomography (SD-OCT) following endoscopic adhesiolysis for failed back surgery syndrome. Methods: Case report. Results: A 47-year-old patient noted progressive and bilateral visual loss immediately after epidural endoscopy and endoscopic adhesiolysis. Funduscopic examination showed multiple Roth spots and retinal hemorrhages at the posterior pole and the retinal midperiphery in both eyes. Spectral-domain optical coherence tomography demonstrated that Roth spots involved the inner retina, while dot hemorrhages involved the outer retina. Most retinal hemorrhages and Roth spots resolved over 6 weeks, with complete functional recovery in both eyes. However, SD-OCT revealed multiple areas of disruption of the outer retinal layers in the left eye. Conclusions: Roth spots and retinal hemorrhages can occur after endoscopic spinal surgery. Although hemorrhages resolve quickly over few weeks, SD-OCT can demonstrate that retinal damage might persist, especially in the outer retina. This finding may explain cases of incomplete recovery of visual function after complicated endoscopic adhesiolysis.
KW - Endoscopic adhesiolysis
KW - Failed back surgery syndrome
KW - Optical coherence tomography
KW - Roth spots
KW - SD-OCT
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U2 - 10.5301/ejo.5000679
DO - 10.5301/ejo.5000679
M3 - Article
C2 - 26428215
AN - SCOPUS:84954073964
VL - 26
SP - e11-e13
JO - European Journal of Ophthalmology
JF - European Journal of Ophthalmology
SN - 1120-6721
IS - 1
ER -