Suspected bacterial endophthalmitis following sustained-release dexamethasone intravitreal implant: a case report

Korean J Ophthalmol. 2014 Jun;28(3):275-7. doi: 10.3341/kjo.2014.28.3.275. Epub 2014 May 19.

Abstract

A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.

Keywords: Dexamethasone implant; Endophthalmitis; Ozurdex; Pars plana vitrectomy.

Publication types

  • Case Reports

MeSH terms

  • Device Removal / methods
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Diagnosis, Differential
  • Drug Implants / adverse effects*
  • Endophthalmitis / diagnosis
  • Endophthalmitis / etiology*
  • Endophthalmitis / surgery
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / etiology*
  • Eye Infections, Bacterial / surgery
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Humans
  • Intravitreal Injections / adverse effects
  • Male
  • Middle Aged
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / drug therapy*
  • Vitrectomy

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone