Intravitreal Dexamethasone Implantation in a Behcet's Disease Patient with Macular Edema, Vasculitis after Cataract Surgery

Ji Young Lee; Ho Ra; Eun Chul Kim; Nam Yeo Kang; Ji Won Baek

doi:10.3341/jkos.2019.60.2.195

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Lee, Ra, Kim, Kang, and Baek: Intravitreal Dexamethasone Implantation in a Behcet's Disease Patient with Macular Edema, Vasculitis after Cataract Surgery

Case Report

Journal of the Korean Ophthalmological Society 2019; 60(2): 195-200.

Published online: 15 February 2019

DOI: https://doi.org/10.3341/jkos.2019.60.2.195

Intravitreal Dexamethasone Implantation in a Behcet's Disease Patient with Macular Edema, Vasculitis after Cataract Surgery

Ji Young Lee, MD, Ho Ra, MD, PhD, Eun Chul Kim, MD, PhD, Nam Yeo Kang, MD, PhD, Ji Won Baek, MD, PhD

Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

Address reprint requests to Ji Won Baek, MD, PhD. Department of Ophthalmology, Bucheon St. Mary's Hospital, #327 Sosa-ro, Bucheon 14647, Korea. Tel: 82-32-340-2125, Fax: 82-32-340-2126, md.jiwon@gmail.com

Received 26 July 2018 Revised 13 September 2018 Accepted 24 January 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of macular edema and retinal vasculitis treated with intravitreal dexamethasone implantation in a Behcet's disease patient after cataract surgery.

Case summary

A 26-year-old male with Behcet's disease, without recurrence of uveitis for 3 months, underwent phacoemulsification and posterior chamber intraocular lens implantation for a cataract in the left eye. The preoperative best corrected visual acuity (BCVA) of the left eye was 0.15. At day 1 after surgery, his BCVA was 0.4, and slit lamp examination of his left eye revealed a mild anterior chamber reaction. At 1 week after surgery, he presented with left vision impairment, his BCVA was 0.04, and mild inflammation was observed in both the anterior chamber and the vitreous in his left eye. Unilateral macular edema was confirmed with optical coherence tomography, and fluorescein angiography revealed retinal vasculitis on the fovea and peripheral retina. Intravitreal dexamethasone implantation was performed in his left eye, 1 month after treatment, the macular edema and retinal vasculitis had improved, and the BCVA of his left eye was 0.8.

Conclusions

In patients with Behcet's disease, intravitreal dexamethasone implantation can be an effective treatment option for macular edema and retinal vasculitis after cataract surgery.

Keywords: Behcet disease, Dexamethasone, Macular edema, Vasculitis

Figures and Tables

Figure 1

Ultra-widefield fundus photographs and ultra-widefield fluorescein angiographic images in both eyes. Fundus photographs shows vitreous opacity (A, B). Fluorescein angiographic images shows diffuse perivascular leakage (fern-like appearance) (C, D).

Figure 2

Ultra-widefield fundus photograph, optical coherence tomographic image and ultra-widefield fluorescein angiographic images in left eyes. (A) Fundus photograph shows vitreous opacity and retinal hemorrhage at parafovea and ischemia in the left eye. (B) Optical coherence tomography shows severe macular edema in the left eye. (C-E) Fluorescein angiograph shows diffuse perivascular leakage.

Figure 3

Ultra-widefield fundus photograph, optical coherence tomographic image in left eye. Fundus photograph (A) and optical coherence tomography (B) of the left eye show improved macular edema and vasculitis after 1 month after intravitreal dexamethasone implantation.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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