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

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.