Retinal hemorrhage as a consequence of epidural steroid injection
F. H. Kushner and J. C. Olson
Halifax Eye Associates, Daytona Beach, Fla.
OBJECTIVE: To report that retinal hemorrhage is an important but uncommon
complication of epidural steroid injection, a procedure frequently employed
to alleviate chronic back pain. DESIGN: Patients who complained of visual
field defects or blurred vision after receiving the injection received
complete eye examinations, including fundus photography and fluorescein
angiography. They were then followed up as their clinical situation
dictated. SETTING: Patients were examined in an outpatient setting in our
offices. PATIENTS: Between 1989 and 1992, five eyes of four female patients
ranging in age from 35 to 81 years were evaluated and followed up. RESULTS:
Examination and photographic documentation showed that these eyes had
retinal hemorrhages, often distributed in a petaloid pattern, which
resulted in transient loss of vision from 6 weeks to 6 months. CONCLUSIONS:
Retinal hemorrhage is an uncommon but significant and previously
unemphasized complication of epidural steroid injection for chronic back
pain. This procedure should be carefully considered, particularly in
one-eyed patients and those with bleeding problems, and patients should be
fully informed that this can happen despite appropriate care and technique.
