Hemorrhagic Occlusive Retinal Vasculitis After Cataract Surgery in a Patient with Leukocytoclastic Vasculitis




To report a case of hemorrhagic occlusive retinal vasculitis after uncomplicated cataract surgery in a patient with leukocytoclastic vasculitis (LCV).


An 80-year-old woman was admitted to our clinic with the complaint of vision loss in both eyes for 2 years. Slit lamp examination were unremarkable except for grade 3 cataracts in both eyes. The patient\’s right eye underwent an uncomplicated phacoemulsification cataract extraction with implantation of a posterior chamber intraocular lens under topical anesthesia. Patient had painless visual loss in the right eye 2 days after surgery.


On examination, visual acuity was hand movements in the right eye. Slit lamp examination revealed mild corneal edema, hypopyon measuring 1mm in height. It was noticed that the patient didn\’t use topical dexametasone treatment after surgery. Moxifloxacin 0.5% eye drop and dexametasone 0.1% eye drop hourly, cyclopentolate hydrocloride 1% 2 times daily and oral metilprednisolone 1mg/kg once daily were started. During the etiological investigation, it was found out that the patient was followed up for 2 years with the diagnosis of LCV in the Department of Rheumatology. During the follow-up, anterior chamber reaction resolved. Fundus could not be seen clearly. Extensive tractional bands, vitreous opacity were present in B mode ultrasonography. Pars plana vitrectomy was performed. During vitrectomy, it was seen that the retinal vascular structures were empty and tangential and axial tractions in the posterior pole, macular migration to the optic nerve, diffuse preretinal hemorrha ges around the arcuades and widespread preretinal snowball inflammatory deposites in the periferal retina.


Leukocytoclastic vasculitis is an immun complex mediated small-vessel vasculitis. Ocular manifestations are rare and there have been reports suggesting associations of iritis, episkleritis, retinitis and panuveitis. Our patient is the first case of hemorrhagic occlusive retinal vasculitis after uncomplicated cataract surgery with LCV diagnosis.


Özlem Tök
Isparta, Turkey
Email : esattok@yahoo.com
Cell Phone: +905054862260
Work Phone: +902462119286