Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema
PURPOSE: The purpose of this study was to report a rare case of subretinal lodgement of Ozurdex® implant (Allergan Inc., Irvine, CA, USA) and its effect on macular edema in a case of central retinal vein occlusion (RVO). METHODS: A rare complication of subretinal lodgement of Ozurdex® implant withou...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Oman Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ojoonline.org/article.asp?issn=0974-620X;year=2017;volume=10;issue=2;spage=100;epage=102;aulast=Karandikar |
| _version_ | 1818518681188040704 |
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| author | Smita Shriram Karandikar George J Manayath Veerappan Saravanan Siddharth Narendran Venkatapathy Narendran |
| author_facet | Smita Shriram Karandikar George J Manayath Veerappan Saravanan Siddharth Narendran Venkatapathy Narendran |
| author_sort | Smita Shriram Karandikar |
| collection | DOAJ |
| description | PURPOSE: The purpose of this study was to report a rare case of subretinal lodgement of Ozurdex® implant (Allergan Inc., Irvine, CA, USA) and its effect on macular edema in a case of central retinal vein occlusion (RVO).
METHODS: A rare complication of subretinal lodgement of Ozurdex® implant without retinal perforation was encountered in a case of RVO with intractable macular edema. As associated retinal perforation was not noted, no intervention was done. The patient was regularly followed up at 1 month, and the effect on macular edema and intraocular pressure was analyzed.
RESULTS: The corticosteroid pellets got disintegrated and totally absorbed with a subtle chorioretinal scar by the 3rd follow-up month without any intervention. Even though subretinal, it was capable of reducing macular edema by 181 microns at 1 month postinjection, and its effect started wearing off by 2 months.
DISCUSSION: Subretinal lodgement of Ozurdex® implant is rare and preventable, yet a potential complication of intravitreal implants which is now in vogue. We speculate a too acute angle of injection or incomplete insertion of the drug delivery system applicator (DDS) away from the limbus or perhaps less refined previous DDS applicator to be a cause for subretinal delivery of the implant. The early disintegration of implant occurred due to breach in structural integrity that caused loss of controlled drug release and rapid absorption. It reduced macular edema up to 2 months without elevating intraocular pressure.
CONCLUSION: A more widespread application of any technology always portends a more significant risk for complications, and an ophthalmologist should be aware of this potential risk. Though subretinal, corticosteroid implant was capable of reducing macular edema by 181 microns by 1 month and its effect wore off by 2 months. |
| first_indexed | 2024-12-11T01:13:34Z |
| format | Article |
| id | doaj.art-4b365d3e0560484eabf1643a02cc9c82 |
| institution | Directory Open Access Journal |
| issn | 0974-620X |
| language | English |
| last_indexed | 2024-12-11T01:13:34Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Oman Journal of Ophthalmology |
| spelling | doaj.art-4b365d3e0560484eabf1643a02cc9c822022-12-22T01:25:57ZengWolters Kluwer Medknow PublicationsOman Journal of Ophthalmology0974-620X2017-01-0110210010210.4103/0974-620X.209120Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edemaSmita Shriram KarandikarGeorge J ManayathVeerappan SaravananSiddharth NarendranVenkatapathy NarendranPURPOSE: The purpose of this study was to report a rare case of subretinal lodgement of Ozurdex® implant (Allergan Inc., Irvine, CA, USA) and its effect on macular edema in a case of central retinal vein occlusion (RVO). METHODS: A rare complication of subretinal lodgement of Ozurdex® implant without retinal perforation was encountered in a case of RVO with intractable macular edema. As associated retinal perforation was not noted, no intervention was done. The patient was regularly followed up at 1 month, and the effect on macular edema and intraocular pressure was analyzed. RESULTS: The corticosteroid pellets got disintegrated and totally absorbed with a subtle chorioretinal scar by the 3rd follow-up month without any intervention. Even though subretinal, it was capable of reducing macular edema by 181 microns at 1 month postinjection, and its effect started wearing off by 2 months. DISCUSSION: Subretinal lodgement of Ozurdex® implant is rare and preventable, yet a potential complication of intravitreal implants which is now in vogue. We speculate a too acute angle of injection or incomplete insertion of the drug delivery system applicator (DDS) away from the limbus or perhaps less refined previous DDS applicator to be a cause for subretinal delivery of the implant. The early disintegration of implant occurred due to breach in structural integrity that caused loss of controlled drug release and rapid absorption. It reduced macular edema up to 2 months without elevating intraocular pressure. CONCLUSION: A more widespread application of any technology always portends a more significant risk for complications, and an ophthalmologist should be aware of this potential risk. Though subretinal, corticosteroid implant was capable of reducing macular edema by 181 microns by 1 month and its effect wore off by 2 months.http://www.ojoonline.org/article.asp?issn=0974-620X;year=2017;volume=10;issue=2;spage=100;epage=102;aulast=KarandikarDexamethasone implantretinal venous occlusionsubretinal Ozurdex® implant |
| spellingShingle | Smita Shriram Karandikar George J Manayath Veerappan Saravanan Siddharth Narendran Venkatapathy Narendran Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema Oman Journal of Ophthalmology Dexamethasone implant retinal venous occlusion subretinal Ozurdex® implant |
| title | Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema |
| title_full | Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema |
| title_fullStr | Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema |
| title_full_unstemmed | Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema |
| title_short | Iatrogenic subretinal injection of Ozurdex® implant and its effect on macular edema |
| title_sort | iatrogenic subretinal injection of ozurdex r implant and its effect on macular edema |
| topic | Dexamethasone implant retinal venous occlusion subretinal Ozurdex® implant |
| url | http://www.ojoonline.org/article.asp?issn=0974-620X;year=2017;volume=10;issue=2;spage=100;epage=102;aulast=Karandikar |
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