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Peer-reviewedCC BY 4.0International Journal of Retina and Vitreous

Variable retinal presentations after retrobulbar needle perforation: a case series

  • Eva Ramón Juan1
  • David Oliver-Gutiérrez2
  • Alberto Salmoral Lorenzo-Arroyo1
  • Claudia Garcia-Arumí3,4
  • José Garcia-Arumí3,4
4 affiliations
  1. 1General Ophthalmology Department, IMO Grupo Miranza, Balmes, 322, Barcelona, 3 1. 08006 Spain
  2. 2Retina and Vitreoretinal Surgery Department, Hospital Universitari Bellvitge (HUB), Barcelona, Spain
  3. 3Retina and vitreoretinal Surgery Department, IMO Grupo Miranza, Barcelona, Spain
  4. 4Retina and vitreoretinal Surgery Department, Hospital Universitari Vall d’Hebrón (HUVH), Barcelona, Spain
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Abstract

Background: Retrobulbar anesthesia is widely used in ophthalmic surgery due to its rapid onset and effective akinesia. However, although uncommon, globe perforation remains one of its most severe complications and may lead to a wide spectrum of posterior segment damage. While incidence and risk factors have been extensively described, less attention has been given to the management of the resulting retinal and choroidal injuries.

Main body: We report a retrospective case series of four patients with retinal or choroidal complications following retrobulbar needle perforation. Clinical presentations were heterogeneous, including proliferative vitreoretinopathy, subretinal hemorrhage, choroidal neovascularization, and submacular hemorrhage. Management was individualized according to the predominant retinal pathology and included pars plana vitrectomy–based approaches, subretinal recombinant tissue plasminogen activator, and intravitreal anti-vascular endothelial growth factor therapy. Anatomical stabilization was achieved in all cases, with visual outcomes appearing to be influenced by macular involvement and timing of intervention.

Conclusion: Retrobulbar needle perforation can result in diverse retinal pathologies despite a common mechanism of injury. This small case series illustrates the importance of early recognition, multimodal imaging, and individualized management in selected complex cases.

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Cite

BibTeXRIS
BibTeX
@article{juan2026variable,
  title = {{Variable retinal presentations after retrobulbar needle perforation: a case series}},
  author = {Eva Ramón Juan and David Oliver-Gutiérrez and Alberto Salmoral Lorenzo-Arroyo and Claudia Garcia-Arumí and José Garcia-Arumí},
  journal = {International Journal of Retina and Vitreous},
  year = {2026},
  month = jul,
  doi = {10.1186/s40942-026-00897-0},
  url = {https://doi.org/10.1186/s40942-026-00897-0},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Variable retinal presentations after retrobulbar needle perforation: a case series
AU  - Eva Ramón Juan
AU  - David Oliver-Gutiérrez
AU  - Alberto Salmoral Lorenzo-Arroyo
AU  - Claudia Garcia-Arumí
AU  - José Garcia-Arumí
PY  - 2026
DA  - 2026/07/30
JO  - International Journal of Retina and Vitreous
DO  - 10.1186/s40942-026-00897-0
UR  - https://doi.org/10.1186/s40942-026-00897-0
AB  - Background: Retrobulbar anesthesia is widely used in ophthalmic surgery due to its rapid onset and effective akinesia. However, although uncommon, globe perforation remains one of its most severe complications and may lead to a wide spectrum of posterior segment damage. While incidence and risk factors have been extensively described, less attention has been given to the management of the resulting retinal and choroidal injuries.  Main body: We report a retrospective case series of four patients with retinal or choroidal complications following retrobulbar needle perforation. Clinical presentations were heterogeneous, including proliferative vitreoretinopathy, subretinal hemorrhage, choroidal neovascularization, and submacular hemorrhage. Management was individualized according to the predominant retinal pathology and included pars plana vitrectomy–based approaches, subretinal recombinant tissue plasminogen activator, and intravitreal anti-vascular endothelial growth factor therapy. Anatomical stabilization was achieved in all cases, with visual outcomes appearing to be influenced by macular involvement and timing of intervention.  Conclusion: Retrobulbar needle perforation can result in diverse retinal pathologies despite a common mechanism of injury. This small case series illustrates the importance of early recognition, multimodal imaging, and individualized management in selected complex cases.
SN  - 2056-9920
ER  -