Acute bacterial endophthalmitis following dexamethasone intravitreal implant: A case report

Abstract

A 54-year-old male presented to our ophthalmology clinic with a diagnosis of the right central retinal vein occlusion with macular edema. The patient was treated with dexamethasone intravitreal implant. Three days after the implant insertion, the patient experienced pain, redness and blurred vision in the same eye. With a provisional diagnosis of acute endophthalmitis, a combination of ceftazidime 2.25 mg/0.1 ml and vancomycin 1 mg/0.1 ml was injected intravitreally. One week after the treatment, endophthalmitis signs and symptoms subsided. This report presents a case of endophthalmitis following dexamethasone intravitreal implant, with a favorable outcome after treatment with intravitreal antibiotic injection without removal of the implant.

Acute Atypical Endophthalmitis Following Intravitreal Sustained-release Dexamethasone Implant: A Case Series

“…6 On the other hand, in two reports of post-Ozurdex implantation-related endophthalmitis, intravitreal antibiotics were used to successfully treat the condition without the need for PPV or implant removal. 3,8 The cases reported by Esen et al, 3 Yorgun et al, 4 and Al Zamil et al 8 had vitreous samples sent for culture, but all returned negative which suggests a noninfective etiology. These cases, however, were distinctly different from our cases as the duration to presentation from the initial injection was significantly shorter (2-3 days) as compared with our cases (7-35 days).…”

“… 6 On the other hand, in two reports of post-Ozurdex implantation-related endophthalmitis, intravitreal antibiotics were used to successfully treat the condition without the need for PPV or implant removal. 3 , 8 …”

“…1,2 Only a handful of case reports of postinjection endophthalmitis are found in the literature with most being bacterial in nature. [3][4][5][6][7][8][9] We present a case series of three patients who developed acute endophthalmitis after intravitreal injection of sustained-release dexamethasone (Ozurdex) implantation with atypical presentation.…”

“…1,2 Only a handful of case reports of postinjection endophthalmitis are found in the literature with most being bacterial in nature. 3–9…”

Clinical Outcomes of Patients With Endophthalmitis After Dexamethasone Intravitreal Implant

“…There are a few case reports of DEX-associated endophthalmitis in the recent literature. 4,5 However, there is limited information regarding the incidence, presentation, management, and outcomes of endophthalmitis following intravitreal DEX implant. In this study, we report a case series of DEX-associated endophthalmitis in a single practice and discuss the clinical findings associated with each case.…”