A clinical case of intravitreal implant dexamethasone (Ozurdex) using in treatment of macular edema associated with non-infectious uveitis

Abstract

Purpose. Demonstration of a clinical case of macular edema treatment associated with non-infectious uveitis by intravitreal injection of a dexamethasone implant (Ozurdex). Material and methods. A clinical case of uveitis associated with rheumatoid arthritis in a 34-year-old female patient is presented. She underwent sequential two intravitreal injections (IVI) of long-acting dexamethasone (Ozurdex implants), with an interval of 3 months. Results. 3 days after Ozurdex IVI Vis OD = 1.0, Vis OS = 0.8 (initially 0.2), intraocular pressure (IOP) OD = 18 mmHg, IOP OS = 19 mmHg. A single cell suspension remained in the vitreous body. The retinal thickness in the macula decreased to 314.5 µm (initial 725.2 µm), and macula volume decreased to 14.1 mm³(initially 18.5 mm³ ). 3 months after IVI of Ozurdex in the vitreous: opacification +2 points, the implant was not detected due to its rapid biodegradation. OCT of the macular area again revealed edema with cystic cavities. Ozurdex was reinjected intravitreally. 3 days after the operation, all signs of the inflammatory process were stopped, Vis OD = 1.0, Vis OS = 1.0, IOP OD = 18 mmHg, IOP OS = 18 mmHg. Conclusion. The Ozurdex implant made it possible to achieve complete regression of macular edema and resorption of cell suspension in the vitreous body. The best-corrected visual acuity (BCVA) indicators increased significantly – from 0.4 to 1.0. Keywords: non-infectious uveitis, macular edema, Ozurdex implant, retinal thickness, macular volume.