Intravitreal Injection Of Dexamethasone Research Articles

Fluocinolone intravitreal implant (Iluvien) for macular edema secondary to immune recovery uveitis in patient with acute myeloid leukemia

PurposeTo report the use of Fluocinolone intravitreal implant (Iluvien) for the treatment of persistent cystoid macular edema (CME) due to immune recovery uveitis syndrome in a patient with previous cytomegalovirus retinitis and acute myeloid leukemia.DesignCase report.MethodsThe clinical history of a patient who received an Iluvien implant in one eye for the treatment of cystoid macular edema due to immune recovery uveitis syndrome, previously treated with peribulbar Triamcinolone and intravitreal Dexamethasone injections, was reviewed.ResultsA 48-year-old woman presented with cystoid macular edema due to immune recovery uveitis syndrome. The patient had a history of cytomegalovirus retinitis 3.5 years prior, secondary to immunosuppressive treatment for an acute myeloid leukemia. Three periocular triamcinolone injections and two dexamethasone intravitreal implants were performed, but the edema recurred, so fluocinolone intravitreal implant was used, achieving a sustained control of the condition at one year of follow-up.ConclusionThe Fluocinolone intravitreal implant may be an effective treatment for persistent CME in patients with immune recovery uveitis syndrome.

Combination Therapy with Anti-VEGF and Intravitreal Dexamethasone Implant for Macular Edema Secondary to Retinal Vein Occlusion

Purpose To compare the safety and efficacy of intravitreal injection of ranibizumab alone or ranibizumab combined with dexamethasone intravitreal implant in the treatment of macular edema secondary to retinal vein occlusion. Study design A single center, case-controlled, prospective cohort study (Clinical Trail Registration Number: ChiCTR2400080048). Methods A total of 44 patients were enrolled and randomized into the ranibizumab group (n = 23) and the combination group (ranibizumab combined with dexamethasone intravitreal implant) (n = 21). All patients received ranibizumab intravitreal injections in the first three months as the initial treatment. For the ranibizumab group, patients might receive repeat injections in case of the recurrence of macular edema; For the combination group, patients received an intravitreal injection of dexamethasone implant after the first injection of ranibizumab at the day 15. The main outcome was best-corrected visual acuity (BCVA) and reduction of central macular thickness. The secondary outcome were the numbers of recurrence, the average injection interval, and the numbers of injection. Adverse events were also recorded. Results The BCVAs in both groups were significantly improved compared with the baselines (all p < 0.001), but more increment in BCVA was noticed at the 3-month in the combination group (p = 0.022). Both groups showed a reduction of central macular thickness at all time points (p < 0.05). However, the combination group did not exhibit higher central macular thickness-reducing effects than the ranibizumab group (p > 0.05). Compared with the combination group, the ranibizumab group suffered a higher number of recurrences of macular edema (p < 0.001), a lower interval of injection (p = 0.050), and a higher number of injection (p < 0.011). The incidence of adverse events was not significant between the two groups (p = 0.944). Conclusions Ranibizumab combined with dexamethasone injection sustainably improved the BCVA of retinal vein occlusion patients with a good safety profile.

Indocyanine green-enhanced transpupillary thermotherapy for juxtapapillary retinal capillary hemangioblastoma.

To study the clinical presentation and treatment outcomes of indocyanine green-enhanced transpupillary thermotherapy (ICG-TTT) for treatment-naïve juxtapapillary retinal capillary hemangioblastoma (JRCH). A prospective interventional case series. The technique involved ICG dye infusion 45 seconds prior to application of TTT. The main study outcomes were local tumor control, resolution of subretinal fluid (SRF), and improvement in best-corrected visual acuity (BCVA). Eight eyes of seven patients (5 males and 2 females) were included. The mean age was 26 years (range: 5-56 years). Systemic evaluation revealed von-Hippel Lindau (VHL) disease in five patients. The most common location was the temporal aspect of the optic disc (5 eyes). The mean basal diameter was 2.9 mm (range: 1-8 mm), and tumor thickness was 1.4 mm (range: 1-4 mm). All eight eyes were treated with multiple sessions of ICG-TTT (mean: 3 sessions). Six eyes received adjuvant intravitreal injection of dexamethasone implant (4 eyes) and/or bevacizumab (4 eyes). Post treatment, six eyes (75%) had tumor regression with reduction of SRF. One eye had a partial response with persisting SRF, and one eye showed poor response to TTT for which external beam radiotherapy was performed. At the last follow-up (median: 11 months; range: 6-29 months), the BCVA remained stable in seven eyes and improved in one eye (hand motion to 20/40). Multiple ICG-TTT sessions can be considered as an alternative treatment option for JRCH with effective local tumor control and SRF resolution.

Evaluation of the Quality of Visual Function and Life of Patients with Diabetic Macular Edema with Vitrectomized and Non-Vitrectomized Eyes on Steroid Therapy

Objectives: to evaluate the dynamics of changes in quality of life in patients with diabetic macular edema (DME) with vitrectomized and non-vitrectomized eyes after intravitreal injection of dexamethasone implant (IVD). Material and methods. 60 patients (60 eyes) were examined, divided into two groups with a diagnosis of diabetic retinopathy, DME and with different vitreous conditions. Group 1 — patients with non-vitrectomized eyes, group 2 — with vitrectomized eyes. Both objective and subjective methods of ophthalmological examination were used, followed by an assessment of the quality of life and visual functions based on the results of a questionnaire conducted to patients using VFQ-25 (visual function questionnaire — 25). Also, all patients of both groups were assessed for best corrected visual acuity (BCVA) before, 1, 3 and 6 months after IVD. Results. In both groups, an increase in the average BCVA after IVD was observed up to 3 months of monitoring (p &lt; 0.01). In addition, the quality of life parameters increased after 1 month of steroid therapy in both groups (p &lt; 0.05), and by 3 and 6 months this trend persisted mainly only for the group with vitrectomized eyes (p &lt; 0.05). Conclusion. IVD in patients with DME can significantly improve the morphofunctional parameters of the macular zone in the eyes with both vitrectomized and non-vitrectomized eyes. The maximum effect of the drug according to the quality of visual functions assessment was observed in 1 month of monitoring in the group with non-vitrectomized eyes. At the same time, the longest increase in quality of visual functions parameters from 3 to 6 months was observed in the group with vitrectomized eyes.

Клинический случай использования интравитреального имплантата дексаметазона (Озурдекса) в лечении макулярного отека, ассоциированного с неинфекционным увеитом

Purpose. Demonstration of a clinical case of macular edema treatment associated with non-infectious uveitis by intravitreal injection of a dexamethasone implant (Ozurdex). Material and methods. A clinical case of uveitis associated with rheumatoid arthritis in a 34-year-old female patient is presented. She underwent sequential two intravitreal injections (IVI) of long-acting dexamethasone (Ozurdex implants), with an interval of 3 months. Results. 3 days after Ozurdex IVI Vis OD = 1.0, Vis OS = 0.8 (initially 0.2), intraocular pressure (IOP) OD = 18 mmHg, IOP OS = 19 mmHg. A single cell suspension remained in the vitreous body. The retinal thickness in the macula decreased to 314.5 µm (initial 725.2 µm), and macula volume decreased to 14.1 mm³(initially 18.5 mm³ ). 3 months after IVI of Ozurdex in the vitreous: opacification +2 points, the implant was not detected due to its rapid biodegradation. OCT of the macular area again revealed edema with cystic cavities. Ozurdex was reinjected intravitreally. 3 days after the operation, all signs of the inflammatory process were stopped, Vis OD = 1.0, Vis OS = 1.0, IOP OD = 18 mmHg, IOP OS = 18 mmHg. Conclusion. The Ozurdex implant made it possible to achieve complete regression of macular edema and resorption of cell suspension in the vitreous body. The best-corrected visual acuity (BCVA) indicators increased significantly – from 0.4 to 1.0. Keywords: non-infectious uveitis, macular edema, Ozurdex implant, retinal thickness, macular volume.

Acute exacerbation of ocular graft-versus-host disease and anterior uveitis after COVID-19 vaccination

BackgroundTo report a case of simultaneous occurrence of acute exacerbation of ocular graft-versus-host disease (GVHD) and anterior uveitis following coronavirus disease 2019 (COVID-19) vaccination.Case presentationA 60-year-old man with primary myelofibrosis and GVHD after receiving allogeneic hematopoietic stem cell transplantation (HSCT), developed acute exacerbation of ocular GVHD and anterior uveitis after receiving first dose of COVID-19 vaccine. The patient developed erythema of the eyelids, conjunctival hyperemia, superficial punctate keratopathy, and prominent anterior chamber inflammation in both eyes. The ocular GVHD and anterior uveitis were managed with mainly topical corticosteroids, antibiotics, lubricants, and systemic corticosteroids, but were difficult to control. Intravitreal injection of dexamethasone was administered, and the inflammation gradually subsided 6 months after the onset of initial symptoms.ConclusionsClinicians should be aware of rare refractory anterior uveitis and acute exacerbation of ocular GVHD after COVID-19 vaccination in patients undergoing HSCT. Early diagnosis and aggressive treatment should be considered to reduce the likelihood of severe complications.

Unilateral Multiple Evanescent White Dot Syndrome-Like Reaction Following the CyberKnife Stereotactic Radiotherapy for Choroidal Malignant Melanoma.

A 58-year-old otherwise healthy man received a diagnosis of choroidal malignant melanoma (CMM) in June 2021 and underwent a single session of (21 Gy) CyberKnife stereotactic radiotherapy (SRT). Eleven months later, we noticed 3+ anterior chamber cells with occasional vitreous cells in the left eye. Though the tumor looked regressed, there were mild optic disc leakage, early hypofluorescent and late hyperfluorescent punctate lesions scattered 360 degrees, and late staining of the mass on fluorescein angiogram. The findings were compatible with a unilateral multiple evanescent white dot syndrome (MEWDS)-like reaction that was most likely related to CyberKnife SRT-induced tumor necrosis, and a dexamethasone implant was administered intravitreally into the left eye together with topical steroids. A second intravitreal injection of dexamethasone was given three months later due to remittance of the angiographic features. As there are only a few reports on CyberKnife SRT for the treatment of CMM, we wanted to share our interesting observation of a post-treatment MEWDS-like reaction likely related to tumor necrosis syndrome with the ophthalmic community.

Evaluation of changes in epivascular glia before and after intravitreal dexamethasone implant: An OCT pilot study

PurposeTo detect changes in epivascular glia (EVG) in diabetic retinopathy after intravitreal dexamethasone implant using en face optical coherence tomography (enface OCT) and OCT angiography (OCTA) and to correlate improvements in functional and structural features. MethodsA total of 38 eyes of 38 patients were enroled in this prospective study. They were divided into two different study groups: the first group including 20 eyes with diabetic retinopathy type 1 complicated by macular oedema and the control group including 18 eyes from 18 healthy age-matched patients. The main outcome measures were: (i) differences at baseline in the foveal avascuar zone (FAZ) area in the study group versus control; (ii) the presence of epivascular glia in the study group versus control, (iii) differences at baseline between foveal macular thickness versus control; (iv) changes in foveal macular thickness, FAZ and epivascular glia in the study group before and after intravitreal dexamethasone implant. ResultsAt baseline FAZ area detected at OCTA was larger in the study group than in the control group, and epivascular glia was only detected in the study group. Three months after intravitreal injection of dexamethasone implant in the study group the best corrected visual acuity (BCVA) improved and central macular tickness reduced (P<0.0001). No significant differences were found in FAZ area while epivascular glia disappeared in 80% of the patients after treatment. ConclusionsGlia activation due to retinal inflammation in diabetic retinopathy (DR) can be detected on en face-OCT as epivascular glia. Intravitreal dexamethasone (DEX) implant improves both the anatomical and functional condition in the presence of these signs.

Visual and Anatomical Outcomes of a Single Intravitreal Dexamethasone in Diabetic Macular Edema: An 8 Year Real-World Study.

Diabetic macular edema (DME) is a major cause of vision loss in patients with diabetes mellitus. Intravitreal dexamethasone is a treatment option for patients unsuitable for or non-responsive to anti-angiogenic agents. To quantify visual and anatomical outcomes from an initial intravitreal dexamethasone injection over the expected 6-month period of dexamethasone release by the implant. Design and enrolment: This is a retrospective cohort study using electronic medical records of patients reviewed between 1 January 2012 and 1 April 2022. A tertiary eye-care center in London, United Kingdom; Moorfields Eye Hospital National Healthcare System Foundation Trust. The cohort comprised 418 adult patients with DME who received an initial treatment of 700 µg intravitreal dexamethasone in the study period. Of these, 240 patients met the inclusion criteria of ≥2 hospital visits following initial injection (≥1 beyond 6 months) and no previous ocular corticosteroid treatment or missing assessment at baseline. Intravitreal dexamethasone implant (700 µg). Probability of a positive visual outcome, defined as ≥5 or ≥10 Early Treatment Diabetic Retinopathy Study (ETDRS)-letter gain after treatment when compared to baseline (Kaplan-Meier models). From the initial intravitreal dexamethasone injection alone, we observed a >75% chance of gaining ≥5 ETDRS letters and >50% chance of gaining ≥10 ETDRS letters within 6 months. There was less than a 50% chance of sustaining either positive visual outcome beyond 4 months. Most patients can be expected to have a positive visual outcome following an initial injection of dexamethasone implants that subsides within 4 months. Real-world re-treatment was observed to be delayed until after visual benefits were lost in half of the cohort. Further research will be needed to study the effects of delays in re-treatment.

CLINICAL CHARACTERISTICS AND MULTIMODAL IMAGING FINDINGS IN UNILATERAL FROSTED BRANCH ANGIITIS: A CASE REPORT.

Our aim is to report a comprehensive multimodal imaging case of unilateral frosted branch angiitis in a 40-years-old Caucasian female . Case report involving clinical examination, ultra- wide field fundus photograph, ultra-wide field fluorescein angiography (UWFA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). A 40 years old patients presented with unilateral acute vision loss. On fundus examination, extensive retinal veins sheathing, macular edema and vascular congestion were observed while UWFA revealed an hyperfluorescent "hot" optic disc and blood retinal barrier disruption. OCTA displayed foveal avascular zone (FAZ) enlargement and excluded papillary neovascularization. Extensive laboratory work-up for infectious, autoimmune and inflammatory disorders were negative, thus, a diagnose of acute idiopathic unilateral frosted branch angiitis was made. Intravitreal injection of dexamethasone implant was administered with a good clinical response. Multimodal imaging is crucial to correctly diagnose and treat FBA. Up to our knowledge, the use of OCTA as a complementary tool to the diagnostic process in FBA has been described in literature just once as a photo essay of cytomegalovirus-related FBA and it might be of great value for better characterizing clinical features of this disorder and for following disease activity in a non-invasive fashion.

Combination of cataract surgery with intravitreal injection of dexamethasone intravitreal implant (Ozurdex) for uveitis-induced cataract.

To evaluate the long-term results of patients with chronic uveitis-induced cataract by phacoemulsification with IOL implantation and intravitreal injection of dexamethasone (DEX) intravitreal implant (Ozurdex). The study included 32 eyes of 26 patients treated with DEX implant due to chronic uveitis-induced cataract and followed up for at least a year. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber reaction, central macular thickness (CMT), intraoperative and postoperative complications and uveitis recurrence were analyzed retrospectively. A successful surgery was performed in all patients. The average follow-up period was 12mo. The female/male ratio was 13/13. Mean age was 45.65±3.83y (range 26 to 65y). Etiologically, rheumatic arthritis occurred in 6 patients (18.75%), ankylosing spondylitis in 4 (12.50%), HLA-B27 associated uveitis in 3 (9.38%), Vogt-Koyanagi-Harada-associated uveitis in 4 (12.50%) , Behcet's disease in 2 (6.25%), and 7 (21.88%) suffered from unknown diseases. All 32 eyes had varying degrees of improvement at 12mo after surgery, with 2 eyes showing BCVA of 0.1 or below (6.25%), 6 having 0.1-0.5 (18.75%), 18 of 0.5-1.0 (56.25%), and 6 of 1.0 or above (18.75%). No cases with increased IOP were observed. The values of mean CMT was increased at day 1, decreased at 1, 3mo after surgery and increased at 6, 12mo after surgery. No severe uveitis reactions, such as fibrinous exudates in the anterior chamber and exudative membrane formation on the anterior surface of the IOL, were observed after surgery. The present studies show that intravitreal injection of Ozudex during cataract operation can provide a new option for the clinical treatment of uveitis-induced cataract.

Optical coherence tomography and Scheimpflug imaging of the iridocorneal angle following intravitreal injection of different medications: A longitudinal analysis.

Intravitreal injection of medications induces a sudden increase in posterior segment volume and pushes iris plane anteriorly to narrow iridocorneal angle. The aim of this study to follow and define longitudinal course of these changes following intravitreal injection of 3 different anti-vascular endothelial growth factor (VEGF) medications or dexamethasone implant. This prospective, longitudinal study included 89 eyes of 89 patients that had an intravitreal injection of bevacizumab (n=20) or ranibizumab (n=26) or aflibercept (n=22) or dexamethasone implant (n=21). All the participants had a detailed ophthalmological examination including anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging of the iridocorneal angle, evaluation of anterior chamber depth (ACD), axial length with optical biometry and endothelial cell counts with specular microscopy just before the injection, at post-injection day 1, and post-injection 1st month. Iridocorneal angle became significantly wider following intravitreal injection of dexamethasone implant at nasal and temporal quadrants at the post-injection 1st month both in AS-OCT (p=0.006, p=0.002, respectively) and Scheimpflug imaging (p=0.003, p=0.004, respectively). Small changes were observed in iridocorneal angle following anti-VEGF injections but these small could not be confirmed in both imaging techniques. There were also no changes in ACD, axial length and endothelial counts in all groups. Dexamethasone implants induced widening of iridocorneal angle that persisted at the post-injection 1st month both at nasal and temporal quadrants. However, intravitreal injection of anti-VEGF agents did not have a comparable effect on iridocorneal angle.

Systemic Outcomes of Intravitreal Injections of Dexamethasone and Anti-Vascular Endothelial Growth Factor.

Intravitreal dexamethasone and anti-vascular endothelial growth factor (anti-VEGF) medications have revolutionized ocular disease management and favorable ocular safety profiles, but few studies have compared their systemic adverse events (SAEs). This study investigated the SAEs of intravitreal dexamethasone and anti-VEGFs by using real-world data. This retrospective cohort study sourced medical records from the largest multi-institutional database in Taiwan. Patients who received intravitreal dexamethasone (n = 137) or anti-VEGFs (n = 10,345) between 2014 and 2019 were enrolled. Propensity score matching was performed to achieve homogeneity between the two groups. Subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs) were calculated using the Fine-Gray model. Systemic as well as ocular clinical events and systemic biomarkers after 1-year follow-up were compared. Both groups demonstrated comparable risks of major cardiac adverse events (SHR 1.57, 95% CI 0.29-8.55), heart failure (SHR 0.62, 95% CI 0.07-5.33), major bleeding (SHR 0.23, 95% CI 0.03-1.77), all-cause admission (SHR 0.73, 95% CI 0.41-1.30), and all-cause death (SHR 2.11, 95% CI 0.35-12.71). There were no significant differences in longitudinal changes in systolic and diastolic blood pressure, glycated hemoglobin, low-density lipoprotein, estimated glomerular filtration rate, or alanine aminotransferase between the groups. Both groups had a similar incidence of cataract surgery. Although the dexamethasone group exhibited a relatively high prevalence of antiglaucomatous medication use, there was not a significantly higher incidence of glaucoma surgery. Intravitreal dexamethasone and anti-VEGF medications had comparable systemic safety profiles in our study. Both drugs represent efficacious and safe therapies for ocular diseases.

Occlusive Cytomegalovirus Panuveitis following Intravitreal Dexamethasone Implant.

To report a case of unilateral cytomegalovirus (CMV) panuveitis with occlusive vasculitis following injection of intravitreal dexamethasone implant in a patient with type 2 diabetes mellitus. Observational case report. A 60-year-old immunocompetent male with well-controlled type 2 diabetes mellitus was treated with intravitreal dexamethasone implant for recurrent uveitis that was responsive to steroids. 3 months after implantation, patient develops panuveitis with occlusive vasculitis. Anterior chamber tap confirms diagnosis of cytomegalovirus retinitis. Intravitreal foscarnet and oral valganciclovir led to quiescent disease. Patients treated with local immunosuppressants should be monitored carefully to assess treatment response and complications, even in the absence of frank immunodeficiency. Quantitative viral PCR can be an effective way to monitor treatment response to antiviral therapy.

Surgical removal of dexamethasone implant (Ozurdex) accidentally injected inside crystalline lens

AbstractPurpose: To present a rare case of accidental injection of dexamethasone implant (Ozurdex) into crystalline lens in a patient with diabetic macular edema, which was surgically removed by uneventful phacoemulsification.Methods: A 41‐year‐old male patient had been treated with multiple aflibercept intravitreal injections for diabetic macular edema in his right eye, but he showed suboptimal response. So, we decided to treat this patient with intravitreal injection of Ozurdex. The implant was inadvertently injected inside the lens. Subcapsular cataract was formed during the course of 3 weeks at the precise site of the insertion and there was an increase of intraocular pressure, which was addressed with topical anti‐glaucoma medication. Despite all that, the macular edema regressed.Results: We performed cataract surgery and simultaneous removal of the Ozurdex implant 3 months after the injection. Phacoemulsification was completed without any complications as the posterior capsule remained intact the entire surgical time and the one‐piece intraocular lens was successfully placed in the bag.Conclusions: The injection of intravitreal dexamethasone implant (Ozurdex) into the crystalline lens is a rare complication that can be effectively managed with the surgical extraction of the implant from the lens and implantation of a one‐piece intraocular lens in the posterior chamber in the bag without any complications.

Опыт применения глюкокортикоидов у пациентов с макулярным отеком, связанным с саркоидозом

Purpose. To evaluate the results of treatment of patients with sarcoidosis with chronic non-infectious uveitis complicated by macular edema by intravitreal injection of a glucocorticosteroid implant with previously used methods. Material and methods. The study performed a comparative analysis of data from patients with cystic macular edema against the background of chronic non-infectious uveitis associated with sarcoidosis, with corrected visual acuity of more than 0.05 (according to the Golovin-Sivtsev table). Group 1 (prospective analysis) included the results of treatment of patients with sarcoidosis with corticosteroid implants (4 eyes, 4 patients). In the 2nd group (retrospective analysis of the medical history), patients underwent peribulbar administration of betamethasone (9 eyes, 7 patients). The parameters were analyzed after 2.0±0.5, 4.0±0.5 and 6.0±0.5 months with assessment of maximally corrected visual acuity (BCVA), OCT, color photography, and IOP control. The risk of recurrence of macular edema when comparing groups was assessed over a 6-month follow-up period. Results. During the observed period in both groups, no complications were detected in any case. According to visometry and OCT, the best functional results were obtained in group 1. Average visual acuity after 6 months. was 0.7±0.1, the thickness of the retina in the central zone was 331±15µm. Conclusion. According to the results of the study, it was found that intravitreal injection of dexamethasone implant in its effectiveness surpasses the previously used peribulbar injections of betamethasone in terms of the quality of restoration of visual functions, the effectiveness of reducing macular edema and the duration of remission of the chronic inflammatory process. Key words: sarcoidosis, chronic uveitis, macular edema, dexamethasone implant, surgical treatment

CLINICAL OUTCOMES OF PATIENTS WITH ENDOPHTHALMITIS AFTER DEXAMETHASONE INTRAVITREAL IMPLANT.

To report a case series of endophthalmitis associated with intravitreal dexamethasone injections in a single practice and to discuss the clinical findings and visual outcomes of each case. All endophthalmitis cases following intravitreal dexamethasone injections performed from January 1, 2014 to October 20, 2020 were identified using Wills Eye/MidAtlantic billing records. The diagnosis, clinical information, and microbiology were confirmed for each case. Data were analyzed using Excel (Microsoft Excel, Redmond, WA). Four cases of endophthalmitis were identified from 3,925 intravitreal dexamethasone injections in a single practice and one case was referred from an outside institution, resulting in an incidence of 0.102% (1 in 981 injections). Mean age was 82.3 years (range, 63-88 years) with a mean of 11.3 intravitreal dexamethasone injections performed (range, 2-30 injections) before endophthalmitis. Cases presented with endophthalmitis a mean (SD) of 3.6 (1.64) days after causative injection. Three cases grew gram-positive organisms. All patients responded to intravitreal antibiotics. Mean logarithm of the minimal angle of resolution visual acuity at causative injection, endophthalmitis presentation, 3 months, and last follow-up was 0.44 (20/55), 2.22 (20/3,319), 1.18 (20/303), and 1.46 (20/577), respectively. Endophthalmitis following intravitreal steroid injections may occur more frequently than other intravitreal injections. Dexamethasone-attributed endophthalmitis remains uncommon, and prompt intravitreal antibiotic treatment seems to be effective in this series.

Unilateral retinal crystalline deposition

A 71-year-old asymptomatic female was referred to a tertiary retina clinic for refractile changes in the left eye macula. Her past ocular history included panuveitis and cystoid macular edema OS secondary to HLA-B27 4 years prior. Her ocular inflammation and cystoid macular edema stabilized following 1 intravitreal dexamethasone injection. Visual acuity was 20/20 OU with no active ocular inflammation. Dilated fundus examination revealed fine crystalline deposits in the macula, sparing the retinal periphery OS (Fig.

“INTRAVITREAL DEXAMETHASONE AN EFFECTIVE TREATMENT IN CASES OF RECURRENT MACULAR OEDEMA IN CRVO”

Retinal vein occlusion is second most common retinal vascular disease after diabetic retinopathy. Macular oedema secondary to RVO is the second most common retinal vascular disease after diabetic retinopathy. Various treatment options have been mentioned in literature i.e., Anti VEGF injections, retinal laser, corticosteroids, vitrectomy, etc. We here with report a case of CRVO with recurrent macular edema even after 2 monthly doses of intravitreal ranibizumab injections who responded very well by single intravitreal injection of dexamethasone implant (Ozurdex). Till 3 months post injection of single dexamethasone implant, visual acuity was stable at 6/12 with maintaining of central foveal thickness below 250 microns without requiring of any other further mode of treatment. So we conclude that dexamethasone intravitreal implant is a very good effective mode of treatment in such cases of CRVO with recurrent macular edema.

The efficacy of intravitreal dexamethasone implant for branch retinal vein occlusion related macular edema

Background: To study the efficacy of intravitreal injection of dexamethasone implant on central macular thickness in patients with BRVO.Methods: A prospective, longitudinal and interventional study was conducted on 30 patients of BRVO presenting to our OPD over a period of one year. Thorough history and detailed ocular examination was done. All cases included in this study received intravitreal injection of dexamethasone implant and were followed up at the first, third and sixth month post-injection to record any change in BCVA, CMT and IOP.Results: In this study, the mean age of patients was 60.67±7.02 years with a M:F ratio of 1:2. Maximum patients (46.6%) were of 61-70 years age group. A significant change from baseline was observed in BCVA and CMT at 1, 3 and 6 months post injection. BCVA significantly improved at 6th month (0.46±0.20 log MAR) compared to the mean BCVA at 3rd month (0.39±0.15 log MAR) (p&lt;0.001). At the 6th month follow up, the mean CMT (338.33±77.91 µm) (p&lt;0.001) was significantly lower compared to the baseline value (536.23±114.56 µm) (p&lt;0.001) but got significantly increased compared to the mean CMT at third month (p&lt;0.001). IOP values were significantly higher at 1 month (p&lt;0.001) and 3 months (p&lt;0.001) compared to the baseline value. Conclusions: Dexamethasone implant 0.7 mg is beneficial in the improvement of BCVA and treatment of macular edema due to BRVO. However, any beneficial effect on visual acuity and macular edema on OCT seen initially, starts weaning off after 3 months.