Jiao Cheng, Prabakaran Ganesh, Berk Thomas, Hossain Homaira Ayesha, Arepalli Sruthi
Medical College of Georgia, Augusta University, Augusta, GA, USA.
University of North Carolina, Chapel Hill, NC, USA.
Am J Ophthalmol Case Rep. 2024 Dec 19;37:102240. doi: 10.1016/j.ajoc.2024.102240. eCollection 2025 Mar.
To report a case of persistent bilateral sclerouveitis following bilateral bimatoprost implantation (Durysta) that required implant removal and oral steroid course.
A 75-year-old Caucasian male with no prior ocular inflammation experienced bilateral sclerouveitis post bilateral bimatoprost implantation. Despite implant removal from both eyes, the ocular inflammation persisted, showing cystoid macular edema in both eyes and exudative retinal detachment in the right. A comprehensive assessment revealed no clear etiology and no definitive systematic inflammatory syndrome. The ocular inflammation was unresponsive to topical steroids and only receded following weeks-long course of oral steroids. Eventually, the patient required immunosuppression due to recurrence of the inflammation.
The persistence and severity of this inflammatory response to bimatoprost implants, despite its removal, highlight the importance of considering patient-specific risk factors and tailoring management accordingly. Clinicians should be prepared for possible severe reactions requiring intervention.
报告一例双侧植入比马前列素（Durysta）后发生持续性双侧巩膜葡萄膜炎的病例，该病例需要取出植入物并进行口服类固醇疗程治疗。
一名75岁无既往眼部炎症史的白种男性在双侧植入比马前列素后发生双侧巩膜葡萄膜炎。尽管两只眼睛的植入物均已取出，但眼部炎症仍持续存在，双眼均出现黄斑囊样水肿，右眼出现渗出性视网膜脱离。全面评估未发现明确病因，也未发现明确的系统性炎症综合征。眼部炎症对局部类固醇治疗无反应，仅在经过数周的口服类固醇疗程后才消退。最终，由于炎症复发，患者需要进行免疫抑制治疗。
尽管已取出比马前列素植入物，但这种炎症反应的持续性和严重性凸显了考虑患者特定风险因素并相应调整治疗方案的重要性。临床医生应做好应对可能需要干预的严重反应的准备。
