We report the case of a 71-year-old man who presented 2 years following renal transplantation with diffuse, unilateral cytomegalovirus retinitis five weeks after receiving an intravitreal dexamethasone implant device for the management of central retinal vein occlusion. Examination of the left eye showed diffuse retinal hemorrhages, attenuated and tortuous retinal vessels, and superior retinal whitening. The patient was successfully treated with serial intravitreal foscarnet injections and oral valganciclovir with disease regression observed by 12 weeks after presentation. The patient\'s visual acuity and examination remained stable at 9-months follow-up.

BACKGROUND: We aimed to investigate the anatomical features of optical coherence tomography (OCT) and vitreous cytokine levels as predictors of outcomes of combined phacovitrectomy with intravitreal dexamethasone (DEX) implants for idiopathic epiretinal membrane (iERM) treatment.
METHODS: A prospective, single-masked, randomized, controlled clinical trial included 48 eyes. They were randomly assigned in a 1:1 ratio to undergo the DEX group (combined phacovitrectomy with ERM peeling and Ozurdex implantation) and control group (phacovitrectomy only). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed at 1 d, 1 week, 1 month, and 3 months. The structural features of OCT before surgery were analysed for stratified analysis. Baseline soluble CD14 (sCD14) and sCD163 levels in the vitreous fluid were measured using ELISA.
RESULTS: BCVA and CMT were not significantly different in the DEX and control groups. Eyes with hyperreflective foci (HRF) at baseline achieved better BCVA (Ptime*group=0.746; Pgroup=0.043, Wald χ²=7.869) and lower CMT (Ptime*group = 0.079; Pgroup = 0.001, Wald χ²=6.774) responses to DEX during follow-up. In all patients, the mean vitreous level of sCD163 in eyes with HRF was significantly higher than that in eyes without HRF (P = 0.036, Z=-2.093) at baseline. In the DEX group, higher sCD163 predicted greater reduction in CMT from baseline to 1 month (r = 0.470, P = 0.049).
CONCLUSIONS: We found that intraoperative DEX implantation did not have beneficial effects on BCVA and CMT over a 3-month period in all patients with iERM, implying that the use of DEX for all iERM is not recommended. In contrast, for those with HRF on OCT responded better to DEX implants at the 3-month follow-up and thier vitreous fluid expressed higher levels of sCD163 at baseline. These data support the hypothesis that DEX implants may be particularly effective in treating cases where ERM is secondary to inflammation.
BACKGROUND: The trail has been registered at Chinese Clinical Trail Registry( https://www.chictr.org.cn ) on 2021/03/12 (ChiCTR2100044228). And all patients in the article were enrolled after registration.

OBJECTIVE: To evaluate the short-term effects (hours-days) of intravitreal dexamethasone implant (IDI) in eyes with diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) injections.
METHODS: This was a prospective, single-arm, interventional clinical series. Eyes with DME and 3-9 injections of ranibizumab without a good response were included. Patients underwent a single IDI. Best-corrected visual acuity (BCVA) measurement, complete ophthalmic evaluation, and spectral-domain optical coherence tomography (SD-OCT) were performed at baseline, 2 h, 3 h, 24 h, 7 days, and 1 month. The main outcomes were change in central retinal thickness (CRT) on SD-OCT and BCVA.
RESULTS: Fifteen eyes of 15 patients were included. Mean CRT decreased after treatment from 515.87 µm ± 220.00 µm at baseline to 489.60 µm ± 176.53 µm after 2 h (p = 0.126), and 450.13 µm ± 163.43 at 24 h (p = 0.006). Change in BCVA was from 0.85 ± 0.44 logMAR baseline to 0.58 ± 0.37 log MAR at 1 month (p = 0.003).
CONCLUSIONS: Eyes treated with IDI showed significant decrease in CRT detectable 1 day after injection. In some patients, the effect could be observed 3 h post-implantation.
BACKGROUND: Clinicaltrials.gov NCT05736081 . Registered 20 February 2023, Retrospectively registered.

BACKGROUND: We aimed to explore microvascular changes evaluated with optical coherence tomography angiography (OCTA) in patients undergoing epiretinal membrane (ERM) pars-plana vitrectomy (PPV) combined with intravitreal Ozurdex implantation, compared with standard PPV. (2) Methods: Prospective interventional analysis on 25 eyes undergoing PPV + Ozurdex (Group A) and 25 eyes undergoing PPV alone. Best corrected visual acuity (BCVA) and OCTA parameters, such as vessel density (VD) of the superficial and deep capillary plexi (SCP and DCP) in the whole 6.4 mm × 6.4 mm and fovea area, were evaluated preoperatively and 3 months after surgery. (3) Results: Postoperative BCVA significantly improved in both groups. No cases of post-operative cystoid macular edema (CME) were reported in Group A vs. two eyes in Group B. In Group A we found a statistically significant increase of SCP\'s VD in either the whole image (from 42.1 ± 4.1 to 45.6 ± 4.3%, p = 0.01) and the fovea image (from 38.5 ± 7.5 to 41.7 ± 4.2%, p = 0.03). In Group B, we reported no significant variations in the SCP\'s VDs. In the DCP, VD significantly increased only in the whole image in Group A. Stage 4 ERMs showed the greatest improvement in VD, especially in Group A. (4) Conclusions: Intraoperative Ozurdex prompted a significant BCVA recovery and limited the occurrence of postoperative CME compared to the standard procedure. Moreover, Ozurdex implant is associated with a better restoration of microvascular structure in SCP and DCP.

OBJECTIVE: We aim to contribute to the literature in terms of treatment safety with our real world data by examining the anterior segment complications and follow-up results of patients who underwent dexamethasone implants in our clinic.
METHODS: The records of patients treated with at least one intravitreal dexamethasone implant for various retinal diseases: diabetic macular edema (265 eyes), central retinal vein occlusion (45 eyes), retinal vein branch occlusion (91 eyes), postoperative cystoid macular edema (18 eyes), non-infectious uveitis (37 eyes) and other (14 eyes) between July 2013 and April 2020 were reviewed.
RESULTS: After 925 injections were applied to 470 eyes of a total of 383 patients, the eyes were controlled during a mean follow-up of 24 months. No complications were detected in 328 eyes. Intraocular pressure (IOP) above 25 mmHg was detected in 97 eyes (20.6%) that had no previous history of ocular hypertension. Of these 97 eyes, 71 (73.1%) eyes with increased IOP were treated with topical monotherapy, 26 (26.8%) eyes were treated with topical combined therapy and 1 (1.03%) patient had glaucoma surgery. Cataracts requiring surgical intervention developed in 55 (%21.73) of 253 phakic eyes. Three patients have anterior chamber dislocation of dexamethasone, 1 patient was hospitalized with sterile endophthalmitis on the 7th day after the injection, and pars plana vitrectomy was performed.
CONCLUSIONS: This study is the first long-term follow-up study in our country evaluating the safety of dexamethasone implant injections in various retinal diseases and presenting the first real world data. Cataract progression and increased IOP were found to be the most common side effects. We observed that the patient\'s diagnosis did not cause a statistically significant change in the observation of side effects. As a result of our findings, close follow-up of IOP after the injection of dexamethasone implants would be appropriate.

UNASSIGNED: The objective of the study is to evaluate anatomical and functional results such as best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) in patients who received intravitreal dexamethasone (DEX) implant for diabetic macular edema (DME), and to compare the efficacy according to patients\' lens status and concurrent phacoemulsification surgery.
UNASSIGNED: A total of 70 eyes of 55 patients with DME who received intravitreal DEX implantation were included in this retrospective study. Patients who received intravitreal DEX implantation were divided into three groups phaco-DEX (group 1), pseudophakic (group 2), and phakic (group 3). The BCVA, CMT, and IOP changes were compared between the three groups.
UNASSIGNED: One month after the intravitreal DEX implant, BCVA improved in all three groups. (p=0.001, p=0.01, and p=0.009, respectively). There was a decrease in CMT at the end of 1st and 4th months in all three groups compared to the preoperative measurements (p=0.005, p<0.001, p<0.001 respectively). While IOP was increased in group 2 and group 3, no IOP increase was observed in group 1. (p=0.41, p=0.01, and p=0.01, respectively).
UNASSIGNED: Combining intravitreal DEX implantation with phacoemulsification surgery seems to be an effective and reliable method in patients with DME accompanied by cataract. The IOP elevation in follow-up visits of phakic and pseudophakic patients after intravitreal DEX implantation was not observed in the Phaco-DEX group.

UNASSIGNED: Nab-paclitaxel is a chemotherapeutic drug used to treat various solid malignant tumors. It was conceived with a solvent free formulation to overcome toxicity events and hypersensitivity reactions associated with paclitaxel. However, it still carries ocular adverse effects. The present review examines nab-paclitaxel related cystoid macular edema (CME) and the available therapeutic options.
UNASSIGNED: The literature was reviewed on nab-paclitaxel related CME on published articles through January 2021 using the keywords \"nab-paclitaxel \"and \"cystoid macular edema\".
UNASSIGNED: Bilateral CME is found in patients in treatment with nab-paclitaxel and causes considerable visual acuity decline. In ophthalmology multimodal imaging has an integral role in the diagnostic work up of patients and shows characteristic findings in nab-paclitaxel related CME. The case of a patient with treatment for bilateral CME is presented and analyzed.
UNASSIGNED: The preferred management strategy for nab-paclitaxel-related CME is drug cessation that leads to complete resolution of edema. When discontinuation of treatment is not possible due to the systemic conditions of patients, effective alternative therapeutic modalities are topical dorzolamide or steroidal treatment. Given the higher complication hazards of intravitreal therapy topical treatment should be preferred owing to comparable efficacy.

Purpose: To report the effect of simultaneous dexamethasone and bevacizumab combination treatment in patients with macular edema secondary to branch retinal vein occlusion (BRVO). Methods: Treatment-naive patients who had a macular edema secondary to BRVO with a duration of less than 1 month were treated either with intravitreal bevacizumab (Group-1) or intravitreal bevacizumab simultaneously combined with dexamethasone intravitreal implant (Group-2). In both groups, patients received monthly bevacizumab injection during the first 3 months. Between months 3 and 12, all patients were allowed to receive pro-re-nata bevacizumab. In Group-2, the first dexamethasone implant injection was simultaneously received with first bevacizumab injections. The patients were evaluated for re-treatment after 6 months and 11 months for second and third dexamethasone simultaneously with intravitreal bevacizumab. Results: In Group-1, 35 eyes of 35 patients and in Group-2, 32 eyes of 32 patients were treated. The mean gains in BCVA were +10.7 letters in the Group-1 and +21.3 letters in the Group-2 (P = 0.021) at month 12. The mean reduction in Central Macular Thickness (CMT) from the baseline were -173.74 μm in the Group-1 and -257.97 μm in the Group-2 (P = 0.0018). In Group-1, the mean intravitreal bevacizumab injection number was 7.18 ± 1.05. In Group-2, the mean intravitreal bevacizumab and dexamethasone injection number was 5.15 ± 1.24. There was a significant difference in mean injection numbers between 2 groups (P = 0.044). Conclusion: In the early period of macular edema adding dexamethasone to bevacizumab therapy does improve visual acuity and CMT, and reduce the injection frequency more than bevacizumab alone.

BACKGROUND: The purpose of this study is to assess the effectiveness of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (intravitreal dexamethasone and peribulbar triamcinolone) in treating pseudophakic macular edema (PME).
METHODS: Retrospective study of 33 eyes. Variables included best corrected visual acuity (BCVA; logMAR scale) and central retinal thickness (CRT) and central choroidal thickness (CCT) assessed with swept-source OCT. All patients were initially prescribed topical NSAIDs and reevaluated after 2 months. If improvement in BCVA or CRT was noted, topical NSAIDs were continued until resolution. If no improvement was observed at 2 months or subsequent visits, intravitreal dexamethasone implant was performed. Patients who refused intravitreal treatment were offered peribulbar triamcinolone.
RESULTS: After treatment with topical NSAIDs for a median of 2 months, BCVA increased significantly from 0.5 to 0.3 while CRT decreased significantly from 435 to 316 μm. PME resolved in 19 of the 33 eyes (57.6%). Of the 14 recalcitrant cases, 13 were treated with corticosteroids. Of these 13 cases, 9 (69.2%) resolved. BCVA increased non-significantly from 0.7 to 0.4. CRT and CCT decreased significantly from 492 to 317 μm and from 204 to 182 μm respectively.
CONCLUSIONS: The overall success rate of the treatment algorithm was greater than 80%, a remarkable finding considering that no randomized study has yet been conducted to determine the optimal therapeutic protocol for PME. This is the first study to evaluate choroidal thickness in PME using SS-OCT, which could play a key role in its pathophysiology and provide useful information to improve the management of PME.

UNASSIGNED: Some patients with diabetic macular edema (DME) fail to completely respond to anti-vascular endothelial growth factor (VEGF) therapy. These patients have a high treatment burden in the absence of significant improvement. We investigate the role of intravitreal dexamethasone insert (IDI) in eyes with super-refractory DME.
UNASSIGNED: A non-randomized interventional study was performed among eyes with super-refractory DME refractory to anti-VEGF therapy. Eyes were treated with IDI after failing clinical response to anti-VEGF, with a minimum of 15 prior. Failure to respond was defined as failure of vision to improve at least one line on Snellen Acuity chart, central subfield thickness (CST) greater than 320 μm, or failure of CST to improve by 10% or more. Eyes with glaucoma or prior uncontrolled steroid-responsive ocular hypertension were excluded. Patient outcomes were analyzed at weeks 6, 12, 24, and year 1.
UNASSIGNED: Six eyes of four patients were identified. All patients had failed aflibercept. The mean number of prior anti-VEGF injections was 34.5. Eyes received an average of 2.92 dexamethasone injections per person-year (PY) and required breakthrough anti-VEGF injection at 1.95/PY. Mean pre-treatment visual acuity was 0.475 LogMAR, improving to 0.342 at week 6, and 0.375 at 1 year. Mean CST pre-injection was 386.5 mm, improving to 315 mm at 1 year. No glaucoma developed.
UNASSIGNED: Intravitreal dexamethasone insert appears effective in eyes with super-refractory DME. IDI resulted in excellent anatomic improvement on SD-OCT as well as modest visual improvement. Injection burden was reduced in those who may otherwise receive years of monthly treatments.