Cystoid Macular Edema Secondary to Rituximab

Abstract

Rituximab has been previously associated with macular edema. Macular edema causing visual loss shortly after receiving rituximab may respond to discontinuation of the rituximab and local steroid injection.

Unique case of macular edema following rituximab treatment for antibody‐mediated rejection in kidney transplant recipient

“…1 DHIS occurs in 1.6% to 8% of HD patients. 3 The pathophysiological mechanism that governs DHIS is a combination of arterial steal syndrome, which results in hypoperfusion distal to the anastomosis, 1,2 and increased resistance to blood flow when there is arterial stenosis in the arm 4 and distal arteriopathy. 5 The current management of DHIS is split into percutaneous and surgical approaches.…”

“…2 The third patient treated with rituximab for IgG4-related disease of the face and sinuses developed bilateral macular edema 6 weeks after rituximab infusion followed by successful intravitreal triamcinolone treatment. 3 Six weeks after rituximab infusion for ABMR treatment our patient was diagnosed with macular edema of the right eye. With other possible causes excluded and good response to intravitreal triamcinolone injection, rituximab remains most likely cause of macular edema in F I G U R E 1 Macular edema of the right eye our patient.…”

“…There are three cases of macular edema occurring after rituximab infusion published in the literature to date. 2,3 We report the first case of macular edema following rituximab infusion for ABMR treatment in kidney transplant recipient.…”

“…1 One of the possible side effects is macular edema with three cases reported in the literature. 2,3 Two patients were treated for refractory manifestations of Wegener's granulomatosis, including scleritis. First patient achieved resolution of scleritis of the right eye but developed macular edema of the same eye 1 month after rituximab infusion.…”

<p>Update in treatment of uveitic macular edema</p>

“…Case reports and small case studies have shown that rituximab may be an effective option for the management of noninfectious uveitis and UME, when conventional or other immunomodulatory treatment fails to control the inflammation 140,141. Despite the mostly positive evidence, some recent case studies reported the development of ME after rituximab administration for the treatment of Wegener’s granulomatosis and an IgG4-related disease of the sinuses 142,143. The use of rituximab is considered relatively safe, with most AEs being transient reactions to the infusion.…”