Hasanreisoglu Murat, Gulpinar Ikiz Gokcen, Aktas Zeynep, Ozdek Sengul
Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.
Int Ophthalmol. 2019 Feb;39(2):485-490. doi: 10.1007/s10792-018-0831-4. Epub 2018 Jan 29.
Tuberculosis-associated uveitis remains a diagnostic and therapeutic challenge. After diagnosis of tuberculosis and initiation of anti-tuberculosis therapy for tuberculosis uveitis, the clinical responses are favorable. However, at 4-6 weeks of the therapy, there commonly occurs paradoxical deterioration due to an increase in inflammation which is often accompanied by cystoid macular edema. Thus, adjuvant administration of anti-inflammatory regimen should be considered. For this purpose, systemic and periocular steroids, systemic and intravitreal immunosuppressive agents have been tested. Nevertheless, there is no report in the literature about intravitreal dexamethasone slow-release implants for the treatment of this inflammatory condition.
Case presentation.
We presented a tuberculosis uveitis case whose ocular inflammation is partially modified by systemic and periocular steroid injections and then well controlled by the intravitreal dexamethasone implant.
Intravitreal dexamethasone implant injection seems to be a safe and potent option for the treatment of macular edema secondary to tuberculosis uveitis.
结核相关性葡萄膜炎仍然是一个诊断和治疗上的挑战。在诊断出结核病并开始针对结核性葡萄膜炎进行抗结核治疗后，临床反应良好。然而，在治疗4至6周时，由于炎症加剧，通常会出现矛盾性恶化，常伴有黄斑囊样水肿。因此，应考虑辅助使用抗炎方案。为此，已经对全身和眼周类固醇、全身和玻璃体内免疫抑制剂进行了测试。然而，文献中尚无关于玻璃体内地塞米松缓释植入物治疗这种炎症性疾病的报道。
病例报告。
我们报告了一例结核性葡萄膜炎病例，其眼部炎症通过全身和眼周类固醇注射得到部分改善，随后通过玻璃体内地塞米松植入物得到良好控制。
玻璃体内注射地塞米松植入物似乎是治疗结核性葡萄膜炎继发黄斑水肿的一种安全有效的选择。
