Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore.
International Eye Cataract Retina Centre, Farrer Park Medical Centre, Singapore; and.
Retin Cases Brief Rep. 2024 Mar 1;18(2):155-158. doi: 10.1097/ICB.0000000000001369.
To present three cases of acute endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex) with atypical presentation and to discuss the management of these patients.
A retrospective case series of three patients with endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex) implantation who presented between July 2020 and August 2020.
Two of three patients who were treated with topical steroid and antibiotic therapy alone showed favorable outcomes and were managed without the need for intravitreal antibiotics or implant removal. One patient who showed initial response to topical therapy subsequently required pars plana vitrectomy, implant removal, and a single empirical dose of intravitreal antibiotics and antifungal agent due to persistent inflammation.
Postintravitreal Ozurdex endophthalmitis, although a rare entity, can present with atypical features of a painless white eye and a delayed onset intraocular inflammation. Although all cases of endophthalmitis should be treated as infective until proven otherwise, it is fair to consider a trial of conservative treatment with topical steroids and antibiotics initially with close monitoring. In cases with poor response to topical therapy, pars planar vitrectomy and implant removal should be strongly considered.
介绍 3 例奥扎格雷钠（Ozurdex）眼内持续释放后发生的非典型性急性眼内炎病例，并讨论这些患者的治疗方法。
回顾性分析 2020 年 7 月至 2020 年 8 月期间接受奥扎格雷钠眼内持续释放植入术后发生眼内炎的 3 例患者的病例系列。
3 例患者中，2 例单独接受局部皮质类固醇和抗生素治疗后，结果良好，无需行眼内抗生素或植入物取出治疗。1 例患者最初对局部治疗有反应，但由于炎症持续存在，随后需要行玻璃体切除术、植入物取出术以及单次经验性眼内抗生素和抗真菌药物治疗。
尽管奥扎格雷钠眼内持续释放后眼内炎是一种罕见疾病，但它可能表现为无痛性白色眼睛和眼内炎症延迟发作的非典型特征。尽管在明确病因之前，所有眼内炎病例均应视为感染性，但可以考虑先使用局部皮质类固醇和抗生素进行保守治疗，并密切监测。对于局部治疗反应不佳的病例，强烈考虑行玻璃体切除术和植入物取出术。
