The modified surgery technique of canaloplasty with suprachoroidal drainage yields the opportunity to optimize the IOP-lowering effect of canaloplasty as a non-penetrating surgical procedure while still offering a more favourable safety profile than trabeculectomy. The suprachoroidal access facilitates the most complicated step of the canaloplasty surgery: the localization of Schlemm's canal.
BackgroundEales’ disease is a difficult to treat idiopathic form of retinal vasculitis. We present such a case with peculiar epidemiology in which the only efficient therapeutic approach in order to maintain functional vision was repeated intravitreal dexamethasone implants (Ozurdex®). To the best of our knowledge this is the first report of this kind in the literature.Case presentationThis is the case of a 40-year-old white woman presenting in 2008 with recurrent floaters accompanied by blurring of vision in her right eye and severe visual loss in her left eye caused by retinal detachment; her age at presentation was 30 years. A diagnosis of Eales’ disease was made by exclusion. She was stable until 2011 after childbirth (cesarean section). Despite aggressive systemic treatment with steroids, azathioprine, and mycophenolate mofetil, progression of the disease was noted that could only be controlled with repeated intravitreal dexamethasone implants (Ozurdex®) injected in her right eye. Her left eye underwent vitrectomy with silicone oil tamponade for tractional retinal detachment with satisfactory anatomical result but vision was limited to light perception.ConclusionsIn our case the systemic therapy was much less effective than the intravitreal sustained-release dexamethasone implant (Ozurdex®) for reducing recurrences and halting disease progression. We believe that recurrent and severe cases could benefit from this addition to the classic treatment armamentarium.Electronic supplementary materialThe online version of this article (10.1186/s13256-018-1768-y) contains supplementary material, which is available to authorized users.
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