Johnny Tang, MD; John J. Weiter, MD, PhD
Potential Financial Conflicts of Interest: None disclosed.
Tang J., Weiter J.; Branch Retinal Artery Occlusion after Injection of a Long-Acting Risperidone Preparation. Ann Intern Med. 2007;147:283-284. doi: 10.7326/0003-4819-147-4-200708210-00021
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Published: Ann Intern Med. 2007;147(4):283-284.
Background: Adverse events of long-acting risperidone are usually attributed to the drug rather than to its preparation. Microsphere technology used for slow release of risperidone in its long-acting formulation is used for other drugs.
Objective: To report a case of branch retinal artery occlusion after injection of long-acting risperidone.
Case Report: A 39-year-old man with a history of psychiatric illness presented to our office with blurred vision in his right eye for 3 days after a right buttock injection of long-acting risperidone (Risperdal Consta, Janssen, Titusville, New Jersey). The patient noted the change in vision about 30 minutes after the injection. He presented to our office 4 days after his injection when the blurry vision did not subside. His visual acuity was 20/20 in both eyes on examination. He had a superior field deficit in the right eye on confrontation. His intraocular pressures were 10 and 11 mm Hg by Goldmann applanation tonometry. His anterior segment examinations were unremarkable. Dilated fundus examination of his right eye revealed a microsphere in his inferior branch retinal artery with occlusion and nonperfusion of the arterial distribution sparing a portion of the fovea (Figure, A). There was some macular edema inferior to the foveal region. His left fundus was unremarkable (Figure, B). A red-free fundus photograph clearly demonstrated the presence of a microsphere lodged within the retinal arteriole (Figure, C). Fluorescein angiography of the right eye revealed poor perfusion along the area distal to the occlusion (Figure, D). Subsequent medical work-up, including consultation with cardiologists, revealed an asymptomatic, persistent foramen ovale.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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