Chin YYB, Yeo TH, Bakthavatsalu M, Zhou WT, Wagle AM, Gopal L, Lim TH. ACUTE ATYPICAL ENDOPHTHALMITIS FOLLOWING INTRAVITREAL SUSTAINED-RELEASE DEXAMETHASONE IMPLANT: A CASE SERIES.
Retin Cases Brief Rep 2024;
18:155-158. [PMID:
36730427 PMCID:
PMC10898540 DOI:
10.1097/icb.0000000000001369]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/01/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE
To present three cases of acute endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex) with atypical presentation and to discuss the management of these patients.
METHODS
A retrospective case series of three patients with endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex) implantation who presented between July 2020 and August 2020.
RESULTS
Two of three patients who were treated with topical steroid and antibiotic therapy alone showed favorable outcomes and were managed without the need for intravitreal antibiotics or implant removal. One patient who showed initial response to topical therapy subsequently required pars plana vitrectomy, implant removal, and a single empirical dose of intravitreal antibiotics and antifungal agent due to persistent inflammation.
CONCLUSION
Postintravitreal Ozurdex endophthalmitis, although a rare entity, can present with atypical features of a painless white eye and a delayed onset intraocular inflammation. Although all cases of endophthalmitis should be treated as infective until proven otherwise, it is fair to consider a trial of conservative treatment with topical steroids and antibiotics initially with close monitoring. In cases with poor response to topical therapy, pars planar vitrectomy and implant removal should be strongly considered.
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