J Korean Ophthalmol Soc.  2013 Jun;54(6):982-986. 10.3341/jkos.2013.54.6.982.

A Case of Dexamethasone Intravitreal Implant Fragmentation During the Injection Procedure in Central Retinal Vein Occlusion

• Youn SM
• Park SJ
• Lee HY
• Lim SH
• Yun IH

• KMID: 2217279
• DOI: http://doi.org/10.3341/jkos.2013.54.6.982

Abstract

PURPOSE
We report a case of dexamethasone intravitreal implant (Ozurdex(R); Allergan, Inc.) fragmentation during the injection procedure in macular edema due to central retinal vein occlusion.
CASE SUMMARY
A 57-year-old man visited our hospital for visual disturbance in his right eye. The patient's best-corrected visual acuity was 0.02 in the right eye and 1.2 in the left eye. After fundus examination, the patient was diagnosed with central retinal vein occlusion with macular edema, thus bevacizumab was injected in the right eye. However, the macular edema did not improve, and a dexamethasone intravitreal implant was injected in the right eye. Immediately after the dexamethasone intravitreal implant injection, on fundus exam, the drug was observed to be fragmented into 3 pieces without any additional treatment. After 2 months, the patient's best-corrected visual acuity was 0.4 in the right eye and 1.2 in the left eye. Macular edema decreased according to optical coherence tomography.
CONCLUSIONS
A case of dexamethasone intravitreal implant fragmentation during an injection procedure has not been previously reported in Korea. Although the drug fragmented, the treatment was effective without complications.

Keyword

Dexamethasone intravitreal implant; Fragmentation; Ozurdex(R)

MeSH Terms

Antibodies, Monoclonal, Humanized
Dexamethasone
Eye
Humans
Korea
Macular Edema
Retinal Vein
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized
Dexamethasone

Figure

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  Figure 1. Patient’s fundus photographs and optical coherence tomography: (A, B) At initial presentation, fundus revealed flame-shaped retinal hemorrhage, retinal vein engorgement and papilledema. A Severe macular edema is seen on OCT. Patient’s visual acuity was 0.02. (C, D) Two month later, fundus revealed resolving retinal hemorrhage and papilledema. A significant de-crease in macular edema is seen on OCT. Patient’s visual acuity was 0.4.

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  Figure 2. (A) Photographs immediately after dexamethasone intravitreal implant injection shows that drug is fragmented to 3 pieces. Slit lamp photographs using contact ocular lens. The fragmented dexamethasone intravitreal implant is seen in the inferior fundus area. (B) Next day, (C) Two months later.

Reference

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