Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-020-01514-w |
| _version_ | 1818259546422902784 |
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| author | Zhi-Yong Zhang Xiu-Yun Liu Tao Jiang |
| author_facet | Zhi-Yong Zhang Xiu-Yun Liu Tao Jiang |
| author_sort | Zhi-Yong Zhang |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-12T18:17:09Z |
| format | Article |
| id | doaj.art-3d637d84c38c48868dbf21f5b9c1d5f2 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-12T18:17:09Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-3d637d84c38c48868dbf21f5b9c1d5f22022-12-22T00:16:15ZengBMCBMC Ophthalmology1471-24152020-06-012011710.1186/s12886-020-01514-wAcute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case reportZhi-Yong Zhang0Xiu-Yun Liu1Tao Jiang2Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityEye Center, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityEye Center, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityAbstract 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.http://link.springer.com/article/10.1186/s12886-020-01514-wAcute retinal necrosisIntravitreal injectionsDexamethasone intravitreal implantRetinal vein occlusion |
| spellingShingle | Zhi-Yong Zhang Xiu-Yun Liu Tao Jiang Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report BMC Ophthalmology Acute retinal necrosis Intravitreal injections Dexamethasone intravitreal implant Retinal vein occlusion |
| title | Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report |
| title_full | Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report |
| title_fullStr | Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report |
| title_full_unstemmed | Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report |
| title_short | Acute retinal necrosis following dexamethasone intravitreal implant (Ozurdex®) administration in an immunocompetent adult with a history of HSV encephalitis: a case report |
| title_sort | acute retinal necrosis following dexamethasone intravitreal implant ozurdex r administration in an immunocompetent adult with a history of hsv encephalitis a case report |
| topic | Acute retinal necrosis Intravitreal injections Dexamethasone intravitreal implant Retinal vein occlusion |
| url | http://link.springer.com/article/10.1186/s12886-020-01514-w |
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