Wu Peipei, Xing Xiaoli, Huan Yu, Li Xinying, Yang Yunhan, Zhang Jing, Ma Xiubin, Li Jun
Qingdao Eye Hospital, Shandong First Medical University, Qingdao, China.
State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.
Ocul Immunol Inflamm. 2025 Jul;33(5):736-742. doi: 10.1080/09273948.2024.2413692. Epub 2024 Oct 9.
To assess the effectiveness and risk of intravitreal injection of dexamethasone implants in treating macular edema (ME) secondary to acute retinal necrosis (ARN).
In this retrospective, noncomparative case series study, five patients who developed secondary ME after ARN and received an intravitreal dexamethasone implant injection were enrolled. The features of secondary ME on OCT and the outcomes of dexamethasone intravitreal implanting were presented.
The mean age of the patients was 59 years (range, 51-61 years). All patients had unilateral involvement, and all 5 eyes showed mild to moderate anterior uveitis, retinal necrosis, and vasculitis. Herpes zoster virus was detected in all eyes using PCR, and timely antiviral and anti-inflammatory treatment was performed. Aqueous humor samples were negative for herpes zoster virus DNA, and resolution of viral retinitis was noted upon the occurrence of ME. Additionally, three eyes received pars plana vitrectomy with silicone oil prior to ME development. All eyes presented with intraretinal fluid, hyper-reflective foci, and impairments of the external limiting membrane/ellipsoid zone at varying degrees on OCT images. Epiretinal membrane was exhibited in 80% of eyes, but no vitreoretinal traction was detected. Subretinal fluid was visible in 60% of eyes. ME was relieved effectively in all eyes after intravitreal dexamethasone implanting. One of these patients experienced three episodes of ME. No recurrence of retinal necrosis or corticosteroid-associated ocular hypertension was observed during the follow-up period.
Intravitreal injection of dexamethasone implants can effectively alleviate ME secondary to ARN and improve visual acuity with no adverse reactions.
评估玻璃体内注射地塞米松植入物治疗急性视网膜坏死（ARN）继发黄斑水肿（ME）的有效性和风险。
在这项回顾性、非对照病例系列研究中，纳入了5例ARN后发生继发性ME并接受玻璃体内地塞米松植入物注射的患者。呈现了继发性ME在光学相干断层扫描（OCT）上的特征以及地塞米松玻璃体内植入的结果。
患者的平均年龄为59岁（范围51 - 61岁）。所有患者均为单眼受累，所有5只眼均表现为轻度至中度前葡萄膜炎、视网膜坏死和血管炎。所有眼经聚合酶链反应（PCR）检测出带状疱疹病毒，并及时进行了抗病毒和抗炎治疗。房水样本中带状疱疹病毒DNA呈阴性，在ME出现时病毒性视网膜炎消退。此外，3只眼在ME发生前接受了玻璃体切割联合硅油填充术。所有眼在OCT图像上均呈现不同程度的视网膜内液、高反射灶以及外限制膜/椭圆体带损伤。80%的眼出现视网膜前膜，但未检测到玻璃体视网膜牵拉。60%的眼可见视网膜下液。玻璃体内注射地塞米松植入物后所有眼的ME均得到有效缓解。其中1例患者经历了3次ME发作。随访期间未观察到视网膜坏死复发或皮质类固醇相关的高眼压。
玻璃体内注射地塞米松植入物可有效减轻ARN继发的ME并提高视力，且无不良反应。
