Difference in the efficacy of intravitreal dexamethasone implant before and after silicone oil removal: A case report

Medicine (Baltimore). 2021 Mar 19;100(11):e25161. doi: 10.1097/MD.0000000000025161.

Abstract

Rationale: An intravitreal dexamethasone (IV-DEX) implant is safe and effective for the treatment of macular edemas; however, the efficacy of IV-DEX implants in silicone oil (SO)-filled eyes remains controversial. There is no previous study comparing an IV-DEX implant in the same eye with and without intravitreal SO.

Patient concerns: A 72-year-old man with proliferative diabetic retinopathy, macular edema, and rhegmatogenous retinal detachment, treated with pars plana vitrectomy with SO tamponade had refractory macular edema.

Diagnosis: Refractory macular edema.

Intervention: Subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation were performed; this was followed by intravitreal SO removal combined with IV-DEX implantation.

Outcomes: The macular edema did not decrease significantly with posterior subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation; however, the edema was relieved after SO removal and a new IV-DEX implantation.

Lessons: IV-DEX implant may be less efficacious in the treatment of macular edema in an SO-filled eye than that in a normal vitreous cavity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Device Removal
  • Dexamethasone / administration & dosage*
  • Diabetic Retinopathy / drug therapy*
  • Drug Implants / administration & dosage
  • Humans
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Male
  • Retinal Detachment / drug therapy*
  • Silicone Oils / administration & dosage*
  • Triamcinolone / administration & dosage
  • Vascular Endothelial Growth Factors / administration & dosage
  • Vitrectomy / methods

Substances

  • Drug Implants
  • Silicone Oils
  • Vascular Endothelial Growth Factors
  • Triamcinolone
  • Dexamethasone