RESUMEN
PURPOSE: To present three cases of acute endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex®) with atypical presentation and to discuss the management of these patients. METHODS: A retrospective case series of three patients with endophthalmitis following intravitreal sustained-release dexamethasone (Ozurdex®) implantation who presented between July 2020 to August 2020. RESULTS: Two out of three patients who were treated with topical steroid and antibiotic therapy alone showed favorable outcomes and were managed without the need for intravitreal antibiotics or implant removal. One patient who showed initial response to topical therapy subsequently required pars plana vitrectomy, implant removal and a single empirical dose of intra-vitreal antibiotics and anti-fungal agent due to persistent inflammation. CONCLUSION: Post intravitreal Ozurdex® endophthalmitis although a rare entity can present with atypical features of a painless white eye and a delayed onset intraocular inflammation. Although all cases of endophthalmitis should be treated as infective until proven otherwise, it is fair to consider a trial of conservative treatment with topical steroids and antibiotics initially with close monitoring. In cases with poor response to topical therapy, pars planar vitrectomy and implant removal should be strongly considered.
RESUMEN
PURPOSE: To report resolution of an abnormal preferential hyperacuity perimetry test result resulting from idiopathic epiretinal membrane after successful pars plana vitrectomy and membrane peeling. METHODS: An observational case report. PATIENT: A 51-year-old otherwise healthy woman presented with a gradual decrease in vision and metamorphopsia in her left eye for a duration of 3 months without any antecedent history of ocular surgery, trauma, or disorder. RESULTS: The Snellen best-corrected visual acuity was 20/80 at presentation resulting from an epiretinal membrane on the posterior pole in the left eye. The preferential hyperacuity perimetry test was abnormal preoperatively but after successful pars plana vitrectomy and membrane peeling, the abnormality resolved completely. The final best-corrected visual acuity was 20/30 at 14 weeks postoperatively along with improvement in her metamorphopsia. CONCLUSION: Epiretinal membrane can produce abnormal preferential hyperacuity perimetry findings that may disappear after its successful surgical removal. The preferential hyperacuity perimetry may be useful to monitor metamorphopsia in epiretinal membrane before and after surgery. Further investigation is warranted.