Intravitreal dexamethasone implant for the treatment of cystoid macular oedema associated with acute retinal necrosis

Majumder, Parthopratim Dutta; Biswas, Jyotirmay; Ambreen, Asra; Amin, Rowayda M.; Pannu, Zahedur Rahman; Bedda, Ahmed M.

doi:10.1186/s12348-016-0116-x

Cited by 11 publications

(6 citation statements)

References 13 publications

(10 reference statements)

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“…The intravitreal DEX implant has been successfully employed in patients with infectious uveitis, though the presence of intraocular infection represents a formal contraindication (Table 3) [118][119][120][121][122][123]. Intravitreal Dex should not be advocated as a primary treatment option in patients with infectious uveitis, however it could represent a useful and minimally invasive therapeutic resource in carefully selected cases.…”

Section: Evidence Of the Efficacy Of Dex In Other Conditionsmentioning

confidence: 99%

See 1 more Smart Citation

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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Section: Evidence Of the Efficacy Of Dex In Other Conditionsmentioning

confidence: 99%

Section: Dex Implant In Other Conditionsmentioning

confidence: 99%

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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“…Systemic administration is often favoured as it is easily ceased should there be clinical deterioration. Promising results with cautious use of local injected corticosteroid together with systemic antiviral cover have recently been reported, however this remains unconventional …”

Section: Treatmentmentioning

confidence: 99%

“…Promising results with cautious use of local injected corticosteroid together with systemic antiviral cover have recently been reported, however this remains unconventional. [69][70][71] Aggressive antiviral therapy has improved visual outcomes after ARN. Rates of severe vision loss to < 6/60 were 76% in the pre-antiviral era as compared to 50% thereafter.…”

Section: Acute Retinal Necrosismentioning

confidence: 99%

Viral retinitis: diagnosis and management in the era of biologic immunosuppression: A review

Lightman

Tomkins-Netzer

2019

Clinical Exper Ophthalmology

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Necrotising retinitis is a rare ocular infection that historically led to high rates of visual morbidity. While acute retinal necrosis occurs in immunocompetent patients, the majority of cases are associated with immunocompromise such as in cytomegalovirus retinitis and progressive outer retinal necrosis. This review summarises the clinical and diagnostic features, management, and outcomes of herpetic retinitis. Iatrogenic immunosuppression is increasingly being utilised for a wide range of indications, and biologic agents especially so due to their targeted nature. While the intended actions are well‐studied, the flow‐on effects and complex interaction with host immunity are not well understood. Furthermore, biologics are frequently used concomitantly with other immunosuppressive agents, potentiating the immunodepression. This article reviews the literature on biologic immunosuppression and viral retinitis, and presents an approach to the vulnerable or affected patient. Early identification, prompt and aggressive treatment, and a multidisciplinary approach to managing immunodeficiency are the cornerstones of management.

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“…Etiologic confirmation via intraocular fluid analysis has shown that varicella zoster virus (VZV), herpes simplex virus (HSV) type-1 and -2, cytomegalovirus (CMV), and Epstein-Barr virus (EBV) are related to the pathogenesis of ARN [10,11]. It is widely known that iatrogenesis immunosuppression associated with subtenonial or intravitreal corticosteroids may predispose patients to ARN, and several reports of ARN have shown its relation to intravitreal Ozurdex® injection [12][13][14]. Here, we report a case of intravitreal Ozurdex® injection-related ARN in an immunocompetent patient with RVO.…”

Section: Introductionmentioning

confidence: 99%

Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report

2020

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Background: Dexamethasone intravitreal implants (0.7 mg) (Ozurdex®, Allergan Inc., Madison, NJ) are FDA approved for managing macular oedema (ME) of retinal vein occlusion (RVO). The major complications associated with intravitreal Ozurdex® implant include increased intraocular pressure and cataract progression. In regard to the occurrence of retinal complications, we report an unusual intravitreal Ozurdex® implantation-related acute retinal necrosis (ARN). Case presentation: A 45-year-old immunocompetent woman with a history of encephalitis presented with photophobia, redness, floaters, and rapidly decreased vision in her left eye. Three and six months ago, she received two doses of intravitreal Ozurdex® implant for ME of RVO. Clinical evaluation, including slit-lamp biomicroscopy, retinal photography, and fluorescein angiography, revealed anterior chamber cells, granulomatous keratic precipitates, cells in the vitreous, optic disc oedema, occlusive retinal vasculitis, scattered retinal haemorrhages, one quadrant of peripheral white areas with retinal necrosis, optic disc and vessels fluorescein staining, and retinal nonperfusion zones. All the above clinical manifestations showed an ARN. Herpes simplex virus was detected in the aqueous and vitreous humour by quantitative polymerase chain reaction testing. Intravenous acyclovir 500 mg tid for 7 days followed by oral valcyclovir was immediately performed for ARN. At 4 months, the patient's condition improved without retinal detachment, and the best-corrected visual acuity remained stable at 0.3. Conclusions: ARN might represent a risk of Ozurdex® administration.

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Intravitreal dexamethasone implant for the treatment of cystoid macular oedema associated with acute retinal necrosis

Cited by 11 publications

References 13 publications

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

Viral retinitis: diagnosis and management in the era of biologic immunosuppression: A review

Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report

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