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Retinal Hemorrhage as a Consequence of Epidural Steroid Injection

Retinal Hemorrhage as a Consequence of Epidural Steroid Injection Abstract We found Drs Kushner and Olson's article1 most instructive and urge them to share their findings with the anesthesiologists performing epidural injections. We would like to add a few comments. The two patients of Clark and Whitwell cited by the authors (their reference 5) received an epidural injection of 120 mL of saline solution but not steroids. This was done under general anesthesia. Both patients still had visual defects at the time of the report, 1 and 3 years after their injections, respectively. We know of a young woman who developed bilateral blind spots immediately following a fast caudal injection of 60 mL of saline solution to treat a postspinal headache; the defect was still present 3 years later. The patients of Drs Kushner and Olson were fortunate to have made a complete recovery. Drs Kushner and Olson's patients received 41 mL of lidocaine in the epidural space. The References 1. Kushner FH, Olson JC. Retinal hemorrhage as a consequence of epidural steroid injection . Arch Ophthalmol . 1995;113:309-313.Crossref 2. Szeifeld M, Ihmeidan IH, Moser MM, Machado R, Klose KJ, Serafini AN. Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space . Anesthesiology . 1986;64:820-822.Crossref 3. Evans W. Intrasacral epidural injection in the treatment of sciatica . Lancet . 1930;2:1225-1229.Crossref 4. Usubiaga J, Usubiaga L, Brea L, Goyena R. Effect of salme injections on epidural and subarachnoid pressures and relation to post-spinal headache . Anesth Analg . 1967;46:293-296. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Retinal Hemorrhage as a Consequence of Epidural Steroid Injection

Defalque, Ray J.; McDanal, Judy T.
Archives of Ophthalmology , Volume 114 (3) – Mar 1, 1996
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References (5)

Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1996.01100130357036
Publisher site
See Article on Publisher Site

Abstract

Abstract We found Drs Kushner and Olson's article1 most instructive and urge them to share their findings with the anesthesiologists performing epidural injections. We would like to add a few comments. The two patients of Clark and Whitwell cited by the authors (their reference 5) received an epidural injection of 120 mL of saline solution but not steroids. This was done under general anesthesia. Both patients still had visual defects at the time of the report, 1 and 3 years after their injections, respectively. We know of a young woman who developed bilateral blind spots immediately following a fast caudal injection of 60 mL of saline solution to treat a postspinal headache; the defect was still present 3 years later. The patients of Drs Kushner and Olson were fortunate to have made a complete recovery. Drs Kushner and Olson's patients received 41 mL of lidocaine in the epidural space. The References 1. Kushner FH, Olson JC. Retinal hemorrhage as a consequence of epidural steroid injection . Arch Ophthalmol . 1995;113:309-313.Crossref 2. Szeifeld M, Ihmeidan IH, Moser MM, Machado R, Klose KJ, Serafini AN. Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space . Anesthesiology . 1986;64:820-822.Crossref 3. Evans W. Intrasacral epidural injection in the treatment of sciatica . Lancet . 1930;2:1225-1229.Crossref 4. Usubiaga J, Usubiaga L, Brea L, Goyena R. Effect of salme injections on epidural and subarachnoid pressures and relation to post-spinal headache . Anesth Analg . 1967;46:293-296.

Journal

Archives of Ophthalmology – American Medical Association

Published: Mar 1, 1996

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