Electroretinographic Response Following Inadvertent Intravitreal Injection of Lidocaine 2%

Abstract

Purpose: To describe the visual and electroretinographic (ERG) outcomes after inadvertent intravitreal injection of lidocaine. Methods: A 75-year-old man with neovascular age-related macular degeneration inadvertently received approximately 0.07 mL of lidocaine 2% intravitreally in his right eye. Serial 30 Hz flicker ERG was performed at 3, 6, and 24 hours postinjection. Results: Visual acuity decreased to count fingers immediately after the injection and returned to baseline of 20/30 within 24 hours. ERG showed increased amplitudes at 3 hours in the affected eye (47.7 microvolts) relative to the unaffected eye (35.7 microvolts) that normalized at hours 6 (23.5 microvolts OD, 29.1 microvolts OS) and 24 (13.4 microvolts OD, 11.8 microvolts OS). Mean implicit time (26.97 ms OD, 27.0 ms OS) was symmetric. Conclusions: In our case, visual acuity reduction and ERG changes specific to 0.07 mL intravitreal lidocaine 2% seem to be transient and may not require any specific therapy other than immediate intraocular pressure control.