Suprachoroidal injection of a dexamethasone implant in a case of secondary macular oedema.

Abstract

BackgroundNon-infectious uveitis (NIU) is a common ocular inflammation that frequently leads to Macular oedema (MO). MO can cause irreversible tissue damage and permanent visual impairment. Dexamethasone implant is approved for intravitreal injection (IV) in the treatment of MO. Despite its proven efficacy, IV poses risks of complications. Recently, suprachoroidal injection has emerged as a novel strategy for targeted drug delivery to the posterior segment of the eye, reducing the risk of complications.Case presentationA 70-year-old woman with no history of diabetes underwent left eye cataract surgery complicated by a capsular rupture and vitreous prolapse, which resulted in the patient becoming aphakic. Later, ophthalmic examination revealed a cystoid MO secondary to a posterior postoperative NIU. Since IV injection of triamcinolone had minimal visual benefit and due to the contraindication of IV cortisone implants, a dexamethasone implant was injected via the suprachoroidal injection, with additional intravitreal triamcinolone. Functional and anatomical recovery was observed after the procedure, with improved visual acuity and no ocular hypertension.ConclusionOur study describes a successful case of dexamethasone implant administered via suprachoroidal space, with no complications and a possible increased effectiveness when compared with intravitreal triamcinolone.