Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis
Abstract Background The treatment of recurrent cystoid macular edema associated with acute retinal necrosis is challenging due to the concern that treatment with intravitreal steroids may reactivate the retinitis. Case report An immunocompetent patient diagnosed with acute retinal necrosis was treat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-10-01
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| Series: | Journal of Ophthalmic Inflammation and Infection |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12348-022-00310-5 |
| _version_ | 1811250028414500864 |
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| author | Ragnhild Øvstebø Sørland Anne Kjersti Erichsen Thora Elisabet Jonsdottir Marius Nordberg Bromnes Peter Mæhre Lauritzen Jon Roger Eidet |
| author_facet | Ragnhild Øvstebø Sørland Anne Kjersti Erichsen Thora Elisabet Jonsdottir Marius Nordberg Bromnes Peter Mæhre Lauritzen Jon Roger Eidet |
| author_sort | Ragnhild Øvstebø Sørland |
| collection | DOAJ |
| description | Abstract Background The treatment of recurrent cystoid macular edema associated with acute retinal necrosis is challenging due to the concern that treatment with intravitreal steroids may reactivate the retinitis. Case report An immunocompetent patient diagnosed with acute retinal necrosis was treated with oral valacyclovir and intravitreal injections of foscarnet. Giant tears in her retina necessitated a vitrectomy with silicone oil. She developed cystoid macular edema after the removal of the silicone oil. The edema responded to high-dose prednisolone but recurred when the dose was tapered to 20 mg daily. Under close surveillance and increased antiviral medication, she was treated with a dexamethasone implant with complete resolution of the edema. Unfortunately, the edema recurred, and the treatment had to be repeated. Over 18 months, she received five dexamethasone implants without recurrence of the viral retinitis. Conclusions This case shows successful treatment of recurring cystoid macular edema following acute retinal necrosis with repeated intravitreal dexamethasone implants in a patient receiving valacyclovir maintenance treatment. |
| first_indexed | 2024-04-12T15:56:51Z |
| format | Article |
| id | doaj.art-1b63843da6484e4787c2dccba3a7a915 |
| institution | Directory Open Access Journal |
| issn | 1869-5760 |
| language | English |
| last_indexed | 2024-04-12T15:56:51Z |
| publishDate | 2022-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Ophthalmic Inflammation and Infection |
| spelling | doaj.art-1b63843da6484e4787c2dccba3a7a9152022-12-22T03:26:19ZengSpringerOpenJournal of Ophthalmic Inflammation and Infection1869-57602022-10-011211310.1186/s12348-022-00310-5Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosisRagnhild Øvstebø Sørland0Anne Kjersti Erichsen1Thora Elisabet Jonsdottir2Marius Nordberg Bromnes3Peter Mæhre Lauritzen4Jon Roger Eidet5Department of Ophthalmology, Oslo University HospitalDepartment of Ophthalmology, Oslo University HospitalDepartment of Ophthalmology, Oslo University HospitalDepartment of Ophthalmology, Oslo University HospitalDepartment of Radiology, Oslo University HospitalDepartment of Ophthalmology, Oslo University HospitalAbstract Background The treatment of recurrent cystoid macular edema associated with acute retinal necrosis is challenging due to the concern that treatment with intravitreal steroids may reactivate the retinitis. Case report An immunocompetent patient diagnosed with acute retinal necrosis was treated with oral valacyclovir and intravitreal injections of foscarnet. Giant tears in her retina necessitated a vitrectomy with silicone oil. She developed cystoid macular edema after the removal of the silicone oil. The edema responded to high-dose prednisolone but recurred when the dose was tapered to 20 mg daily. Under close surveillance and increased antiviral medication, she was treated with a dexamethasone implant with complete resolution of the edema. Unfortunately, the edema recurred, and the treatment had to be repeated. Over 18 months, she received five dexamethasone implants without recurrence of the viral retinitis. Conclusions This case shows successful treatment of recurring cystoid macular edema following acute retinal necrosis with repeated intravitreal dexamethasone implants in a patient receiving valacyclovir maintenance treatment.https://doi.org/10.1186/s12348-022-00310-5Acute retinal necrosisCystoid macular edemaDexamethasone implantValacyclovir |
| spellingShingle | Ragnhild Øvstebø Sørland Anne Kjersti Erichsen Thora Elisabet Jonsdottir Marius Nordberg Bromnes Peter Mæhre Lauritzen Jon Roger Eidet Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis Journal of Ophthalmic Inflammation and Infection Acute retinal necrosis Cystoid macular edema Dexamethasone implant Valacyclovir |
| title | Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| title_full | Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| title_fullStr | Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| title_full_unstemmed | Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| title_short | Successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| title_sort | successful treatment with repeated dexamethasone implant injections for recurrent macular edema after acute retinal necrosis |
| topic | Acute retinal necrosis Cystoid macular edema Dexamethasone implant Valacyclovir |
| url | https://doi.org/10.1186/s12348-022-00310-5 |
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