Cystoid macular edema associated with retinitis pigmentosa resolved by a dexamethasone intravitreal implant
Abstract
Purpose
Cystoid macular edema (CME) is a serious complication that threatens the relatively preserved central vision in patients with retinitis pigmentosa (RP). It occurs in 10–40% of RP patients and, although the exact origin is unknown, a chronic low grade inflammation has been implicated. Currently, there is no gold-standard therapeutic option and treatment should be individualized.
Methods
Interventional case report evaluating the efficacy of intravitreal dexamethasone implant (Ozurdex®) in the management of CME secondary to RP.
Results
A 39-year-old man diagnosed with RP and a 5-month history of deteriorating vision was referred for evaluation. Best-corrected visual acuity (BCVA) was 0.1 and 0.4 in RE and LE, respectively. Slit-lamp examination and intraocular pressure (IOP) were normal in both eyes. On funduscopy, the findings were mottled retinal pigment epithelium (RPE) caused by bone spicule formation and attenuation of blood vessels. Spectral domain optical coherence tomography (SD-OCT) revealed CME in RE which was treated with topical dorzolamide twice a day. As no visual improvement was achieved, two months later the patient underwent 0.7 mg Ozurdex® implant in his RE. One month following the injection CME resolved (from 546 µm to 310 µm) and BCVA improved to 0.3. An IOP spike (34 mmHg) was controlled with topical antiglaucoma medications and no recurrence was observed during 1-year follow-up.
Conclusions
Intravitreal dexamethasone implant (Ozurdex®) seems to be an effective treatment option for patients with macular edema associated with RP.
