ACUTE RETINAL NECROSIS AFTER INTRAVITREAL DEXAMETHASONE IMPLANT. A CASE REPORT
Jazyk angličtina Země Česko Médium print
Typ dokumentu kazuistiky, časopisecké články
PubMed
35760586
DOI
10.31348/2022/17
PII: 131016
Knihovny.cz E-zdroje
- Klíčová slova
- acute retinal necrosis, chronic myeloid leukemia, dexamethasone, diabetic macular edema, diabetic retinopathy, hematopoietic stem cell transplantation, imatinib, imunosupression,
- MeSH
- akutní retinální nekróza * chemicky indukované komplikace diagnóza MeSH
- dexamethason škodlivé účinky MeSH
- diabetická retinopatie * komplikace MeSH
- dospělí MeSH
- implantované léky škodlivé účinky MeSH
- injekce intravitreální MeSH
- lidé MeSH
- makulární edém * diagnóza farmakoterapie etiologie MeSH
- senioři MeSH
- zraková ostrost MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- dexamethason MeSH
- implantované léky MeSH
INTRODUCTION: Ozurdex® (Allergan Pharmaceuticals, Castlebar Road, Westport, Ireland) is an intravitreal implant containing 0.7 mg of dexamethasone. It is indicated in adult patients for the treatment of diabetic macular edema, cystoid macular edema due to central retinal vein occlusion, and in patients with non-infectious uveitis. Common complications after Ozurdex® administration include an increase in intraocular pressure, cataract progression or conjunctival suffusion. Acute retinal necrosis after Ozurdex® administration is a very rare and serious complication. According to our current research, this is the fourth published case. Extreme caution must be exercised when treating immunosuppressed patients with Ozurdex®. CASE REPORT: This is case report about an immunosuppressed 68-year-old patient with diabetic macular edema, who developed acute retinal necrosis 74 days after Ozurdex® implantation. He suffers from chronic myeloid leukemia and takes the cytostatic imatinib 400 mg once per day. Urgent pars plana vitrectomy (PPV) with silicone oil instillation was performed and antiherpetic drugs were initiated intravenously. Serological examination confirmed an active infection of cytomegalovirus etiology (CMV). CONCLUSION: Acute retinal necrosis is a rare necrotizing retinitis. Corticosteroids administered intravitreally reduce the local immune response, which may cause a primary infection or reactivation of a latent viral infection.
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