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Two-sided effect of dexamethasone intravitreal implant: case report

Poster Details

First Author: C.Pinto SPAIN

Co Author(s):    J. Abreu   V. Lozano   P. Rocha   F. Mesa   M. Serrano        

Abstract Details

Purpose:

We present a case report of a female patient with intermediate uveitis episodes in both eyes.

Setting:

Ophthalmology Department. University Hospital of Canary Islands. Tenerife. Spain.

Methods:

69-year-old female with a history of episodes of intermediate uveitis (IU) with macular edema (ME) resistant to intravitreal triamcinolone (IVT) and antiVEG. Finally treated with dexamethasone intravitreal implant (DI) in her right eye (RE) and bilateral improvement of ME. In 2008, the best corrected visual acuity (BCVA) was 20/25 in the right RE and 20/100 in the left eye (LE), highlighting cataract, ME and epiretinal membrane in both eyes. Laboratory tests found positive pANCA and elevated angiotensin-converting enzyme (ACE). 67-gallium-scintigraphy detected activity in the lacrimal gland. For this reason we suspect bilateral IU in the context of ocular sarcoidosis.

Results:

Treatment: Over 6 years, our patient displayed periods of exacerbation. Removal of epiretinal membrane and phacoemulsification surgery was performed in her LE, and she received 5 injections of IVT, 6 injections of bevacizumab.After that, LE presented a 365 macular thickness in optical coherence tomography and BCVA of 20/40. Her RE underwent one IVT and 3 bevacizumab injections, but a 600-ME persisted, so DI was given in her RE. After 4 months, BCVA was 20/32 in RE and 20/25 in LE. RE showed a 310-macular thickness and LE 245-macular thickness, with bilateral improvement of ME.

Conclusions:

During the course of intermediate uveitis, the patient has not showed side effects related to the administration of intravitreal medications. This case describes the bilateral therapeutic effect of unilateral dexamethasone intravitreal implant in the context of probable ocular sarcoidosis, which has poor background in medical literature.

Financial Disclosure:

NONE

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