Intravitreal triamcinolone acetonide in Berger space: A rare complication

We report the case of a 50-year-old male who presented with a diminution of vision in his right eye for the past 6 months and was subsequently found to have central retinal vein occlusion with macular edema. The patient was given intravitreal triamcinolone in view of non-resolving macular edema despite repeated injections of anti-vascular endothelial growth factor. We report this rare occurrence of accidental injection of intravitreal triamcinolone acetonide in Berger space. A careful slit lamp examination before to look for the presence of prominent Berger space in patients planned for intravitreal injections, along with proper counseling of patients to avoid unwanted eye movements during an injection, can be potential ways to prevent such complications. In our case, the triamcinolone resolved after 6 weeks and the intraocular pressure (IOP) spike was managed using glaucoma medications. It is imperative to measure IOP at each visit in these patients and if spikes are noted, they should be managed accordingly.