Efficacy of Intravitreal Dexamethasone Implant in the Treatment of Immune Recovery Uveitis.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2025-04-23 DOI:10.1080/09273948.2025.2496977

Hakan Koc, Ugur Bayram

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引用次数: 0

Abstract

Purpose: To evaluate the efficacy of intravitreal dexamethasone in immune recovery uveitis (IRU) diagnosed with worsening of visual symptoms after recovery of cytomegalovirus (CMV) retinitis caused by acquired immunodeficiency syndrome (AIDS).

Methods: A single case report was obtained from a tertiary referral center and retrospectively evaluated.

Results: A 53-year-old male patient with known AIDS was admitted to our clinic with vision loss that started 1 month before and was diagnosed with CMV retinitis based on clinical findings (CD4 + T lymphocyte count 38 cells/μL). Two months after CMV retinitis regressed with treatment, the patient presented with decreased vision and had isolated bilateral cystoid macular edema, but no retinitis focus was observed. Considering the patient's CD4 + T lymphocyte count of 528 cells/μL and the fact that he was receiving HAART treatment, the patient was diagnosed with immune recovery uveitis. Intravitreal dexamethasone was administered to the patient who did not respond to three repeated doses of subtenon triamcinolone. After the intravitreal dexamethasone implant, the patient's clinical findings and bilateral cystoid macular edema regressed. No reactivation or side effects were observed.

Conclusions: Intravitreal dexamethasone therapy can be an effective and safe treatment for immune recovery uveitis that occurs after immune system recovery in AIDS patients and is resistant to topical or subtenon steroid treatment.

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玻璃体内植入地塞米松治疗免疫恢复性葡萄膜炎的疗效观察。

目的：评价玻璃体内地塞米松治疗获得性免疫缺陷综合征（AIDS）所致巨细胞病毒（CMV）视网膜炎恢复后视力症状加重的免疫恢复性葡萄膜炎（IRU）的疗效。方法：从三级转诊中心获得一例病例报告并进行回顾性评价。结果：患者男，53岁，已知艾滋病患者，1个月前开始视力下降，经临床检查（CD4 + T淋巴细胞计数38个/μL）诊断为巨细胞病毒性视网膜炎。巨细胞病毒性视网膜炎经治疗消退2个月后，患者出现视力下降和孤立性双侧黄斑囊样水肿，但未观察到视网膜炎灶。考虑到患者CD4 + T淋巴细胞计数为528个细胞/μL，并已接受HAART治疗，诊断为免疫恢复性葡萄膜炎。对三次重复剂量的次坦诺曲安奈德无效的患者给予玻璃体内注射地塞米松。玻璃体内地塞米松植入后，患者临床表现及双侧囊样黄斑水肿均有所好转。未观察到再激活或副作用。结论：玻璃体内地塞米松治疗艾滋病患者免疫系统恢复后发生的免疫恢复性葡萄膜炎是一种安全有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.