Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature

Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature

Matteo Sacchi, Edoardo Villani, Francesca Gilardoni, Paolo Nucci University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy Background: Macular edema is a known complication even after uneventful cataract surgery. The chronic use of prostaglandin analogs is a risk factor for...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Sacchi M, Villani E, Gilardoni F, Nucci P
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2014
Materias:
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/040b75690d3d48979bd027789bd828e8
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:040b75690d3d48979bd027789bd828e8
record_format dspace
spelling oai:doaj.org-article:040b75690d3d48979bd027789bd828e82021-12-02T00:35:04ZEfficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature1177-5483https://doaj.org/article/040b75690d3d48979bd027789bd828e82014-07-01T00:00:00Zhttp://www.dovepress.com/efficacy-of-intravitreal-dexamethasone-implant-for-prostaglandin-induc-a17442https://doaj.org/toc/1177-5483 Matteo Sacchi, Edoardo Villani, Francesca Gilardoni, Paolo Nucci University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy Background: Macular edema is a known complication even after uneventful cataract surgery. The chronic use of prostaglandin analogs is a risk factor for the development of pseudophakic cystoid macular edema (CME). Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered first-line therapy but refractory postsurgical CME represents a therapeutic challenge, as there is not an evidence-based treatment.Objective: To report the use of a single implant of intravitreal dexamethasone for tafluprost-associated pseudophakic CME refractory to NSAIDs and to sub-Tenon’s corticosteroid injections.Case report: A 64-year-old female with ocular hypertension treated with tafluprost experienced decreased vision (visual acuity 20/60) and metamorphopsia 2 months after uneventful cataract extraction. Spectral domain optical coherence tomography (SD-OCT) revealed CME. After 1 month of topical and oral NSAIDs, CME was still evident on SD-OCT (visual acuity 20/50). Two sub-Tenon’s betamethasone injections were performed at a 2-week interval. As CME was still present, 2 months after the diagnosis of CME (visual acuity 20/40), the patient underwent a single dexamethasone intravitreal implant. One month later, macular appearance was normal, and visual acuity increased to 20/30. This result was maintained throughout the 6 months of follow-up.Conclusion: In this report, a single implant of intravitreal dexamethasone successfully treated pseudophakic CME associated with the use of prostaglandin analogs unresponsive to NSAIDs and sub-Tenon’s betamethasone. The results of this report need to be corroborated by powered, prospective, randomized trials. The need for repeated treatments as well as the retreatment interval in patients requiring more than a single injection are issues still needing further investigations. Keywords: prostaglandin-induced refractory cystoid macular edema, intravitreal dexamethasone implant, tafluprost, cataract surgery, pseudophakic cystoid macular edemaSacchi MVillani EGilardoni FNucci PDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1253-1257 (2014)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Sacchi M
Villani E
Gilardoni F
Nucci P
Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
description Matteo Sacchi, Edoardo Villani, Francesca Gilardoni, Paolo Nucci University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy Background: Macular edema is a known complication even after uneventful cataract surgery. The chronic use of prostaglandin analogs is a risk factor for the development of pseudophakic cystoid macular edema (CME). Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered first-line therapy but refractory postsurgical CME represents a therapeutic challenge, as there is not an evidence-based treatment.Objective: To report the use of a single implant of intravitreal dexamethasone for tafluprost-associated pseudophakic CME refractory to NSAIDs and to sub-Tenon’s corticosteroid injections.Case report: A 64-year-old female with ocular hypertension treated with tafluprost experienced decreased vision (visual acuity 20/60) and metamorphopsia 2 months after uneventful cataract extraction. Spectral domain optical coherence tomography (SD-OCT) revealed CME. After 1 month of topical and oral NSAIDs, CME was still evident on SD-OCT (visual acuity 20/50). Two sub-Tenon’s betamethasone injections were performed at a 2-week interval. As CME was still present, 2 months after the diagnosis of CME (visual acuity 20/40), the patient underwent a single dexamethasone intravitreal implant. One month later, macular appearance was normal, and visual acuity increased to 20/30. This result was maintained throughout the 6 months of follow-up.Conclusion: In this report, a single implant of intravitreal dexamethasone successfully treated pseudophakic CME associated with the use of prostaglandin analogs unresponsive to NSAIDs and sub-Tenon’s betamethasone. The results of this report need to be corroborated by powered, prospective, randomized trials. The need for repeated treatments as well as the retreatment interval in patients requiring more than a single injection are issues still needing further investigations. Keywords: prostaglandin-induced refractory cystoid macular edema, intravitreal dexamethasone implant, tafluprost, cataract surgery, pseudophakic cystoid macular edema
format article
author Sacchi M
Villani E
Gilardoni F
Nucci P
author_facet Sacchi M
Villani E
Gilardoni F
Nucci P
author_sort Sacchi M
title Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
title_short Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
title_full Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
title_fullStr Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
title_full_unstemmed Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
title_sort efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature
publisher Dove Medical Press
publishDate 2014
url https://doaj.org/article/040b75690d3d48979bd027789bd828e8
work_keys_str_mv AT sacchim efficacyofintravitrealdexamethasoneimplantforprostaglandininducedrefractorypseudophakiccystoidmacularedemacasereportandreviewoftheliterature
AT villanie efficacyofintravitrealdexamethasoneimplantforprostaglandininducedrefractorypseudophakiccystoidmacularedemacasereportandreviewoftheliterature
AT gilardonif efficacyofintravitrealdexamethasoneimplantforprostaglandininducedrefractorypseudophakiccystoidmacularedemacasereportandreviewoftheliterature
AT nuccip efficacyofintravitrealdexamethasoneimplantforprostaglandininducedrefractorypseudophakiccystoidmacularedemacasereportandreviewoftheliterature
_version_ 1718403595454382080

Ejemplares similares