Mid-term safety and effectiveness of intravitreal dexamethasone implant to treat persistent cystoid macular edema in vitrectomized eyes for bacterial endophthalmitis

• Published in: Graefe's archive for clinical and experimental ophthalmology 2022-08, Vol.260 (8), p.2703-2710
• Main Authors: Sborgia, Giancarlo, Niro, Alfredo, Pastore, Valentina, Favale, Rosa Anna, Sborgia, Alessandra, Gigliola, Samuele, Giuliani, Gianluigi, Grassi, Maria Oliva, Coassin, Marco, Aiello, Francesco, Iaculli, Cristiana, Reibaldi, Michele, Boscia, Francesco, Alessio, Giovanni
• Format: Article
• Language: English
• Subjects: Acuity; Biopsy; Dexamethasone; Edema; Endophthalmitis; Eye; Gram-negative bacteria; Medical Ophthalmology; Medicine; Medicine & Public Health; Ophthalmology; Safety; Steroids
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-022-05615-8

Purpose To evaluate the mid-term safety and effectiveness of intravitreal dexamethasone implant (DEX-i) for treating unresponsive to medical therapy cystoid macular edema (CME) in vitrectomized eyes for endophthalmitis. Methods Retrospective and interventional case series study conducted on vitrectomized eyes for endophthalmitis that developed a CME that did not adequately respond to medical therapy, who underwent 0.7-mg DEX-i. Main outcome measures were changes in central retinal thickness (CRT) and best corrected visual acuity (BCVA). Results Eleven eyes were included in the study. Microbiological findings of vitreous biopsies were 7 (63.6%) staphylococcus epidermidis; 3 (27.3%) Pseudomonas aeruginosa ; and 1 (9.1%) Propionibacterium acnes . Median (interquartile range, IqR) duration of CME was 4.0 (3.0–4.0) months. Median (IqR) time between vitrectomy and DEX-i was 9.0 (9.0–11.0) months. Median CRT was significantly decreased from 548.0 (412.8–572.5) µm at baseline to 308.0 (281.3–365.5) µm at month 6 ( p  = 0.0009, Friedman test). Median BCVA significantly improved from 38.0 (30.5–44.8) letters at baseline to 50.0 (46.8–53.0) letters at month 6 ( p