Dexamethasone intravitreal implants (0.7 mg) (Ozurdex, Allergan Inc., Madison, NJ) are FDA approved\nfor managing macular oedema (ME) of retinal vein occlusion (RVO). The major complications associated with\nintravitreal Ozurdex implant include increased intraocular pressure and cataract progression. In regard to the\noccurrence of retinal complications, we report an unusual intravitreal Ozurdex implantation-related acute retinal\nnecrosis (ARN).\nCase presentation: A 45-year-old immunocompetent woman with a history of encephalitis presented with\nphotophobia, redness, floaters, and rapidly decreased vision in her left eye. Three and six months ago, she received\ntwo doses of intravitreal Ozurdex implant for ME of RVO. Clinical evaluation, including slit-lamp biomicroscopy,\nretinal photography, and fluorescein angiography, revealed anterior chamber cells, granulomatous keratic\nprecipitates, cells in the vitreous, optic disc oedema, occlusive retinal vasculitis, scattered retinal haemorrhages, one\nquadrant of peripheral white areas with retinal necrosis, optic disc and vessels fluorescein staining, and retinal\nnonperfusion zones. All the above clinical manifestations showed an ARN. Herpes simplex virus was detected in the\naqueous and vitreous humour by quantitative polymerase chain reaction testing. Intravenous acyclovir 500 mg tid\nfor 7 days followed by oral valcyclovir was immediately performed for ARN. At 4 months, the patientâ??s condition\nimproved without retinal detachment, and the best-corrected visual acuity remained stable at 0.3.\nConclusions: ARN might represent a risk of Ozurdex administration.
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