A 52-year-old man developed severe vision loss in the right eye due to a large retinal detachment. Vitrectomy was performed in that eye, with 15% C3F8 perfluoropropane gas injected into the posterior chamber.1 He transiently regained hand-motion acuity. Posterior chamber paracentesis was performed for elevated intraocular pressure; endophthalmitis was treated with intraocular antibiotics. After 1 week, blurred vision occurred in the left eye, with intact central acuity and a temporal field deficit (figure). CT imaging demonstrated migration of intraocular gas into the optic nerve and chiasm. Chiasmal visual loss is a rare complication of pneumatic retinopexy.
(A) Perimetry testing demonstrated reduced sensitivity in the temporal field of the left eye (contralateral to the retinal detachment). (B, C) A CT scan revealed gas within the right globe, tracking through the right optic nerve into the optic chiasm (arrows). Gas was also present in the lateral ventricles.
Footnotes
Study funding: Supported by an American Academy of Neurology Clinical Research Training Fellowship (S.P.).
Author contributions: Dr. Prasad conceptualized the report, collected data, and composed the manuscript. Dr. Golby conceptualized the report and edited the manuscript.
Disclosure: Dr. Prasad reports no disclosures. Dr. Golby serves on the editorial board of Brain Imaging and Behavior; has a patent pending re: Tissue characterization device; receives research support from Nexstim Oyand and the NIH; and holds stock in Merck Serono and Johnson & Johnson.
- Copyright © 2012 by AAN Enterprises, Inc.
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