Intravitreal Dexamethasone Implant for Cystoid Macular Edema and Inflammation After Scleral Buckling


Intravitreal Dexamethasone Implant for Cystoid Macular Edema and Inflammation After Scleral Buckling by Alessandra Pizzo



Cystoid macular edema may occur following scleral buckling and therefore deteriorate the visual outcome. Inflammation may be the major causative factor in the development of postoperative cystoid macular edema. This case demonstrates the effectiveness of a dexamethasone implant as a treatment after the onset of choroidal inflammation and cystoid macular edema 6 months following scleral buckling and having visual acuity restored.


A 59-year-old phakic woman treated with scleral buckling surgery with cryotherapy as retinopexy for macula-off retinal detachment presented 2 months after surgery with cystoid macular edema with choroidal inflammation. Optical coherence tomography and fluorescein angiography were performed. From the time of the diagnosis, the patient’s condition had been nonresponsive to medical therapy [oral prednisolone (75 mg/day) for 1 week, with a weekly taper of 5 mg; oral administration of acetazolamide (250 mg/day) for 15 days; 1% topical prednisolone acetate 4 times a day; and 0.1% bromfenac sodium eyedrops twice a day for 30 days] and only partially responsive to sub-Tenon
triamcinolone acetonide. An intravitreal implant with a sustained release of 0.7 mg dexamethasone was implanted.


Following an intravitreal injection with a dexamethasone implant, the macular edema subsided completely and optical coherence tomography showed decreased foveal thickness from 510 μm to 220 μm. Choroidal fluorescein leakage disappeared. Bestcorrected visual acuity improved from 0.70 to 0.20 logMAR, a condition maintained throughout the 6 months of follow-up.


Cystoid macular edema and choroidal inflammation are difficult to treat, but the improvement observed in this case of post scleral buckling macular edema and choroidal inflammation showed how a dexamethasone implant proved to be useful during the 6- month follow-up. Many studies have reported the efficacy of 0.7 mg dexamethasone implant in the management of postoperative CME, but to date no studies before this have reported the use of this implant for CME following SB.


Alessandra Pizzo, Laura Foti, Matteo Fallico, Andrea Russo, Antonio Longo, Michele Reibaldi, Teresio Avitabile, Vincenza Bonfiglio
Department of Ophthalmology, University of Catania, Catania – Italy


Alessandra Pizzo
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Laura Foti
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