J Korean Ophthalmol Soc > Volume 54(12); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(12):1939-1944.
DOI: https://doi.org/10.3341/jkos.2013.54.12.1939    Published online December 13, 2013.
A Case of Acute Endophthalmitis Following a Dexamethasone Intravitreal Implant.
Hyun Cheol Han, Jong Wook Bang, Jung Hoon Yum, Jin Hyoung Kim, Do Hyung Lee, Jong Hyun Lee
Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. ophtha@naver.com
유리체강내 덱사메타존 임플란트 삽입 후 발생한 급성 안내염 1예
한현철⋅방종욱⋅염정훈⋅김진형⋅이도형⋅이종현
Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Abstract
PURPOSE
To report a case of acute endophthalmitis after a dexamethasone (Ozurdex(R)) intravitreal implant for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). CASE SUMMARY: A 63-year-old male patient presented with decreased vision in the right eye due to ME secondary to BRVO. The patient was treated with an intravitreal bevacizumab injection, but ME did not improve. Two months after the injection, dexamethasone (Ozurdex(R)) intravitreal implantation was performed. Four days after the implantation, the patient visited our clinic complaining of severe visual disturbance. Slight conjunctival injection was observed and inflammatory cells and hypopyon were found in the anterior chamber. Fundus was not visible due to vitreous opacity. The patient was presumed to have acute endophthalmitis. Vitrectomy, intravitreal antibiotics injection, dexamethasone implant removal and phacoemulsification were performed. After treatment, the patient's fundus markedly improved, the inflammatory response was controlled and coagulase negative staphylococcus was detected from vitreous culture. CONCLUSIONS: In cases of intravitreal dexamethasone implant associated with acute endophthalmitis, careful examination for diagnosis of endophthalmitis is recommended because the patient may not present with severe ocular pain and injection due to anti-inflammatory effect of corticosteroid.
Key Words: Branch retinal vein occlusion;Dexamethasone implant;Endophthalmitis;Intravitreal injection;Macular edema


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