Majumder Parthopratim Dutta, Biswas Jyotirmay, Ambreen Asra, Amin Rowayda, Pannu Zahedur Rahman, Bedda Ahmed Magdy
Medical and Vision Research Foundations, Sankara Nethralaya, 18, College Road, Chennai, 600 006, Tamil Nadu, India.
Ophthalmology department, Faculty of Medicine, Alexandria University, 42 Memphis street, Camp Caesar, Apt #5, Alexandria, Egypt.
J Ophthalmic Inflamm Infect. 2016 Dec;6(1):49. doi: 10.1186/s12348-016-0116-x. Epub 2016 Dec 23.
Acute retinal necrosis is a rare but devastating ocular condition. We report two cases of acute retinal necrosis in immunocompetent patients, complicated by cystoid macular oedema and treated with intravitreal dexamethasone (OZURDEX®) implant.
Two patients diagnosed with acute retinal necrosis were treated with intravenous acyclovir. Both of them developed cystoid macular oedema following resolution of viral retinitis. Ocular condition of the first patient was further complicated by central serous chorioretinopathy. Under unavoidable circumstances, cystoid macular oedema in both the patients was treated with intravitreal dexamethasone implant with great caution. Resolution of cystoid macular oedema without recurrence of viral retinitis was noted in the long-term follow-up.
Findings of the case report should be interpreted cautiously, and extreme caution should be exercised prior deciding the management with a corticosteroid implant in patients with viral retinitis. However, intravitreal dexamethasone implant can be a useful option in selected patients with cystoid macular oedema in acute retinal necrosis.
急性视网膜坏死是一种罕见但具有破坏性的眼部疾病。我们报告了两例免疫功能正常患者发生急性视网膜坏死的病例，这些病例并发了黄斑囊样水肿，并接受了玻璃体内地塞米松（Ozurdex®）植入治疗。
两名被诊断为急性视网膜坏死的患者接受了静脉注射阿昔洛韦治疗。他们在病毒性视网膜炎消退后均出现了黄斑囊样水肿。第一名患者的眼部情况因中心性浆液性脉络膜视网膜病变而进一步复杂化。在不可避免的情况下，两名患者的黄斑囊样水肿均极为谨慎地接受了玻璃体内地塞米松植入治疗。在长期随访中，观察到黄斑囊样水肿消退且病毒性视网膜炎未复发。
该病例报告的结果应谨慎解读，在决定对病毒性视网膜炎患者使用皮质类固醇植入物进行治疗之前应格外谨慎。然而，对于急性视网膜坏死伴有黄斑囊样水肿的特定患者，玻璃体内地塞米松植入可能是一种有用的选择。
