Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Fasce, Francesco; Parodi, Maurizio Battaglia; Knutsson, Karl Anders; Spinelli, Alessandra; Mauceri, Paolo; Bolognesi, Gianluigi; Bandello, Francesco

doi:10.1111/aos.12332

Cited by 29 publications

(33 citation statements)

References 5 publications

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“…ere are some conflicting studies that reported no cataract progression even after accidental intralenticular Ozurdex implant administration [24,25]. In addition, many authors have revealed a resolution of the ME with an intralenticular implant [24,[26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Morphological and Functional Outcomes after Intravitreal Dexamethasone Injection for Macular Edema in Patients with Central Vein Occlusion at 48-Week Follow-Up

Nicula

Nicula²,

Rednik³

et al. 2020

Journal of Ophthalmology

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Purpose. The purpose of the study was to assess the efficacy of intravitreal dexamethasone implant (IDI: Ozurdex®) injection in eyes with macular edema due to retinal vein occlusion. Material and Method. A retrospective, nonrandomized study was conducted in patients with macular edema (ME) due to retinal vein occlusion (RVO) who undertook intravitreal Ozurdex® as first-line treatment. We performed a complete ocular exam including macular OCT. Results. The mean BCVA (logMar) improved from 0.420.42 ± 0.23 logMar at baseline to 0.21 ± 0.23 logMar at 48 weeks in the BRVO group and from 0.72 ± 0.16 logMar at baseline to 0.31 ± 0.23 logMar at 48 weeks in the CRVO group. In both groups, CFT values decreased significantly compared to baseline (p<0.0001 at each timepoint). Reinjection for recurrent macular edema after 18 weeks was indicated in five eyes (41.67%) in the BRVO group and in six eyes (25%) in the CRVO group. Cataract developed in two eyes (16.67%) in the BRVO group and in one eye (4.17%) in the CRVO group. The IOP was higher than 25 mmHg in two cases in the BRVO group (16.66%) and in three cases (8.33%) in the CRVO group. Conclusion. Ozurdex® injected intravitreally significantly improved the mean CFT and BCVA in eyes with macular edema due to retinal vein occlusion.

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Section: Discussionmentioning

confidence: 99%

Morphological and Functional Outcomes after Intravitreal Dexamethasone Injection for Macular Edema in Patients with Central Vein Occlusion at 48-Week Follow-Up

Nicula

Nicula²,

Rednik³

et al. 2020

Journal of Ophthalmology

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“…There have been reports of intralenticular Ozurdex leading to cataract progression in days or months after injection and rise in intraocular pressure requiring intervention. [367] Progression of cataract might take as long as 11 months after injection and might require a second Ozurdex injection for macular edema in the presence of intralenticular Ozurdex. [2] In our case, there was no progression of cataract and intraocular pressure was normal during the entire follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Lenticular injury during Ozurdex implantation is rare but known. [3] To our knowledge, this report provides the longest follow-up of a case of intralenticular Ozurdex without cataract progression.…”

mentioning

confidence: 96%

Immortal Ozurdex: A 10-month follow-up of an intralenticular implant

Poornachandra

Kumar

Jayadev

et al. 2017

Indian J Ophthalmol

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A 78-year-old male who had received a dexamethasone implant (Ozurdex, Allergan, Inc., Irvine, CA, USA) 15 days back for recalcitrant diabetic macular edema in the left eye came to us for a second opinion. On examination, his corrected distance visual acuity was 20/20 in the right eye and 20/40 in the left eye. Early cataractous changes were present in both eyes. The intraocular pressure was within normal limits. The Ozurdex implant was seen lodged in the posterior cortex of the crystalline lens in the left eye, confirmed on anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy. Fundus examination showed moderate nonproliferative diabetic retinopathy in both eyes with macular edema and epiretinal membrane in the left eye, confirmed on OCT. The patient was noncompliant and returned after 10 months. Interestingly, the implant was still present in the same location with the same vision and anterior segment findings as before. The OCT showed a reduction in macular edema. The patient was advised regular follow-up and cataract surgery at a later date.

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“…These procedures carry a risk of surgical complications such as haemorrhage, infection, inflammation and cataract (Fasce et al. ). Furthermore, the surgical approach is expensive and consumes considerable resources in health care.…”

Section: Introductionmentioning

confidence: 99%

“…Two intravitreal implants (Ozurdex Ò , Allergan, Irvine, CA, USA and Iluvien Ò , Alpharetta, GA, USA) with corticosteroids have been approved for the treatment of DME, while triamcinolone injections into vitreous or subtenon are frequently reported off-label treatments for DME (Ozdek et al 2006;Nakano et al 2010;Cho et al 2012;Kriechbaum et al 2014). These procedures carry a risk of surgical complications such as haemorrhage, infection, inflammation and cataract (Fasce et al 2014). Furthermore, the surgical approach is expensive and consumes considerable resources in health care.…”

Section: Introductionmentioning

confidence: 99%

Topical dexamethasone γ‐cyclodextrin nanoparticle eye drops increase visual acuity and decrease macular thickness in diabetic macular oedema

Ohira

Hara

Jóhannesson

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To compare in a randomized, controlled trial topical 1.5% dexamethasone c-cyclodextrin nanoparticle eye drops (DexNP) with posterior subtenon injection of triamcinolone acetonide in diabetic macular oedema (DME). Methods: In this prospective, randomized, controlled trial, 22 eyes of 22 consecutive patients with DME were randomized to (i) topical treatment with DexNP 33/day (4 weeks), 32/day (4 weeks) and 31/day (4 weeks) or (ii) one posterior subtenon injection of 20 mg triamcinolone acetonide. Study visits were at baseline and 4, 8, 12 and 16 weeks. Results: The logMAR (Snellen) visual acuity (mean AE SD) improved significantly with DexNP from 0.41 AE 0.3 (Snellen 0.39) to 0.32 AE 0.25 (0.48) and 0.30 AE 0.26 (0.50) at 4 and 8 weeks, respectively. One-third of the DexNP group improved more than 0.3 logMAR units. For triamcinolone, logMAR changed significantly from 0.42 AE 0.28 (0.38) at baseline to 0.32 AE 0.29 (0.48) at 4w and 0.33 AE 0.37 (0.47) at 12w. The central macular thickness (CMT) decreased significantly with DexNP from 483 AE 141 lm to 384 AE 142 lm at 4w and 342 AE 114 lm at 8w. For triamcinolone, CMT decreased significantly at all time-points: 494 AE 94 lm, 388 AE 120, 388 AE 145, 390 AE 136 and 411 AE 104 lm at 0, 4, 8, 12 and 16 weeks, respectively. There was a modest increase in intraocular pressure (IOP) at all time-points with DexNP while no increase was seen with triamcinolone. Serum cortisol was affected by both treatments. Conclusion: Topical DexNP significantly improve visual acuity and decrease macular thickness in patients with DME. The effect is similar to that from subtenon triamcinolone. A modest increase in IOP was seen with the nanoparticle eye drops, but IOP normalized after the discontinuation of treatment.

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Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Cited by 29 publications

References 5 publications

Morphological and Functional Outcomes after Intravitreal Dexamethasone Injection for Macular Edema in Patients with Central Vein Occlusion at 48-Week Follow-Up

Morphological and Functional Outcomes after Intravitreal Dexamethasone Injection for Macular Edema in Patients with Central Vein Occlusion at 48-Week Follow-Up

Immortal Ozurdex: A 10-month follow-up of an intralenticular implant

Topical dexamethasone γ‐cyclodextrin nanoparticle eye drops increase visual acuity and decrease macular thickness in diabetic macular oedema

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