Intravitreal dexamethasone implant for cystoid macular edema and inflammation after scleral buckling.

Abstract

PURPOSE:

Cystoid macular edema may occur following scleral buckling and therefore deteriorate the visual outcome. Inflammation may be the major causative factor in the development of postoperative cystoid macular edema. This case demonstrates the effectiveness of a dexamethasone implant as a treatment after the onset of choroidal inflammation and cystoid macular edema 6 months following scleral buckling and having visual acuity restored.

METHODS:

A 59-year-old phakic woman treated with scleral buckling for macula-off retinal detachment presented 2 months after surgery with cystoid macular edema with choroidal inflammation. Optical coherence tomography and fluorescein angiography were performed. From the time of the diagnosis, the patient's condition had been nonresponsive to medical therapy and only partially responsive to sub-Tenon triamcinolone acetonide. An intravitreal implant with a sustained release of 0.7 mg dexamethasone was implanted.

RESULTS:

Following an intravitreal injection with a dexamethasone implant, the macular edema subsided completely and optical coherence tomography showed decreased foveal thickness from 510 μm to 220 μm. Choroidal fluorescein leakage disappeared. Best-corrected visual acuity improved from 0.70 to 0.20 logMAR, a condition maintained throughout the 6 months of follow-up.

CONCLUSIONS:

Cystoid macular edema and choroidal inflammation are difficult to treat, but the improvement observed in this case of post scleral buckling macular edema and choroidal inflammation showed how a dexamethasone implant proved to be useful during the 6-month follow-up.

• Authors: Vincenza Bonfiglio, Matteo R Fallico, Andrea Russo, Vittorio De Grande, Antonio Longo, Maurizio G Uva, Michele Reibaldi, Teresio Avitabile
• Journal: European journal of ophthalmology (Eur J Ophthalmol) Vol. 25 Issue 5 Pg. e98-e100 (Jul 30 2015) ISSN: 1724-6016 [Electronic] United States
• PMID: 25790811 (Publication Type: Case Reports, Journal Article)

Chemical References

• Drug Implants
• Glucocorticoids
• Dexamethasone
• Triamcinolone Acetonide

Topics

• Choroiditis (diagnosis, drug therapy, etiology)
• Dexamethasone (administration & dosage)
• Drug Implants
• Female
• Fluorescein Angiography
• Glucocorticoids (administration & dosage)
• Humans
• Intravitreal Injections
• Macular Edema (diagnosis, drug therapy, etiology)
• Middle Aged
• Postoperative Complications
• Retinal Detachment (surgery)
• Scleral Buckling
• Tomography, Optical Coherence
• Triamcinolone Acetonide (administration & dosage)
• Visual Acuity (physiology)