Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal
We present a case of acute endophthalmitis after intravitreal dexamethasone implant injection and discuss the management of this rare and challenging case in which the implant could not be removed. A 50-year-old woman with a history of branch retinal vein occlusion in the right eye was treated with...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/4614802 |
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| author | George G. Bastakis Anastasios Stavrakakis Avgoustinakis Nikolaos Dimitris Dimopoulos George Pappas |
| author_facet | George G. Bastakis Anastasios Stavrakakis Avgoustinakis Nikolaos Dimitris Dimopoulos George Pappas |
| author_sort | George G. Bastakis |
| collection | DOAJ |
| description | We present a case of acute endophthalmitis after intravitreal dexamethasone implant injection and discuss the management of this rare and challenging case in which the implant could not be removed. A 50-year-old woman with a history of branch retinal vein occlusion in the right eye was treated with intravitreal dexamethasone implant injection for macular oedema. Four days after injection, the patient was admitted to the department with acute pain, decreased vision, and redness. A diagnosis of acute post-intravitreal injection endophthalmitis was made. A 23-guage (23G) vitrectomy was performed immediately to remove the implant, and a vitreous tap for culture and polymerase chain reaction was acquired during the procedure. We were unable to remove the dexamethasone implant during the vitrectomy because of dense membrane formation. At the end of the procedure, we injected intravitreal antibiotics (vancomycin and amikacin), and the patient was treated with fortified topical antibiotics and steroids. At the time of writing, 5 years later, the patient retains a best corrected visual acuity of 10/10 (6/6) with dexamethasone implant therapy maintenance. Intravitreal dexamethasone implant-associated endophthalmitis is a rare and challenging condition. Immediate 23G pars plana vitrectomy, even without removal of the implant, can lead to favourable visual results. |
| format | Article |
| id | doaj-art-ce147b37d68d45739df486e733c31259 |
| institution | DOAJ |
| issn | 2090-6722 2090-6730 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-ce147b37d68d45739df486e733c312592025-08-20T03:19:41ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302018-01-01201810.1155/2018/46148024614802Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant RemovalGeorge G. Bastakis0Anastasios Stavrakakis1Avgoustinakis Nikolaos2Dimitris Dimopoulos3George Pappas4Ophthalmology Clinic, Medical Retina & Vitreoretinal Surgery Department, Venizeleio Hospital of Crete, Knossos Avenue 44, Heraklion of Crete, GreeceOphthalmology Clinic, Medical Retina & Vitreoretinal Surgery Department, Venizeleio Hospital of Crete, Knossos Avenue 44, Heraklion of Crete, GreeceOphthalmology Clinic, Medical Retina & Vitreoretinal Surgery Department, Venizeleio Hospital of Crete, Knossos Avenue 44, Heraklion of Crete, GreeceOphthalmology Clinic, Medical Retina & Vitreoretinal Surgery Department, Venizeleio Hospital of Crete, Knossos Avenue 44, Heraklion of Crete, GreeceOphthalmology Clinic, Medical Retina & Vitreoretinal Surgery Department, Venizeleio Hospital of Crete, Knossos Avenue 44, Heraklion of Crete, GreeceWe present a case of acute endophthalmitis after intravitreal dexamethasone implant injection and discuss the management of this rare and challenging case in which the implant could not be removed. A 50-year-old woman with a history of branch retinal vein occlusion in the right eye was treated with intravitreal dexamethasone implant injection for macular oedema. Four days after injection, the patient was admitted to the department with acute pain, decreased vision, and redness. A diagnosis of acute post-intravitreal injection endophthalmitis was made. A 23-guage (23G) vitrectomy was performed immediately to remove the implant, and a vitreous tap for culture and polymerase chain reaction was acquired during the procedure. We were unable to remove the dexamethasone implant during the vitrectomy because of dense membrane formation. At the end of the procedure, we injected intravitreal antibiotics (vancomycin and amikacin), and the patient was treated with fortified topical antibiotics and steroids. At the time of writing, 5 years later, the patient retains a best corrected visual acuity of 10/10 (6/6) with dexamethasone implant therapy maintenance. Intravitreal dexamethasone implant-associated endophthalmitis is a rare and challenging condition. Immediate 23G pars plana vitrectomy, even without removal of the implant, can lead to favourable visual results.http://dx.doi.org/10.1155/2018/4614802 |
| spellingShingle | George G. Bastakis Anastasios Stavrakakis Avgoustinakis Nikolaos Dimitris Dimopoulos George Pappas Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal Case Reports in Ophthalmological Medicine |
| title | Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal |
| title_full | Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal |
| title_fullStr | Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal |
| title_full_unstemmed | Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal |
| title_short | Acute Onset of Exogenous Endophthalmitis after Dexamethasone Implant Injection Treated without Implant Removal |
| title_sort | acute onset of exogenous endophthalmitis after dexamethasone implant injection treated without implant removal |
| url | http://dx.doi.org/10.1155/2018/4614802 |
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