Abstract
PURPOSE: Large amounts of volatile organic compounds (VOCs) are contained in printing inks and paint materials. The inhalation of VOCs causes a variety of adverse health effects, and we report our findings in a rare case of bilateral cystoid macular edema (CME) associated with retinal vein occlusion (RVO) that was exacerbated after painting work. OBSERVATIONS: A 60-year-old male house painter with bilateral RVO developed a persistent CME. He was treated with triamcinolone acetonide and anti-VEGF intravitreal injections, and later with vitrectomy combined with cataract surgery in both eyes due to a persistent bilateral CME. The CME was partially resolved but the CME recurred immediately after beginning his painting work. Urinary metabolites of paint-related VOCs such as 3-methylhippurate, mandelate, and phenylglyoxylate were very high, with an increase of 2700-7000 % compared with normal values. After resigning from the paint job, the patient's CME improved in both eyes. CONCLUSIONS AND IMPORTANCE: A CME might be exacerbated by the exposure to paint-related VOCs. Our findings suggest that reducing and avoiding the occupational exposure to VOCs and regular measurements of urinary VOC concentration are important for those who work in the printing and painting industries.