Título

INTRAVITREAL INJECTION OF DEXAMETHASONE IMPLANT IN TREATMENT OF MACULAR EDEMA SECONDARY TO HERPES VIRUS

Introdução / Purpose

To present a case of macular edema secondary to Herpes virus treated with intravitreal injection of dexamethasone implant.

Material e Método / Methods

Data were collected from the patient's medical records after authorization.

Resultados / Results

Female, 53 years with history of hyperemia and flashes in left eye, in biomicroscopy it presented corneal endothelioma and keratic precipitates, visual acuity (VA) 20/20 both eyes. With suspicion of herpetic ceratouveitis it was requested retinal mapping, serologies and started prednisolone 1%. After 3 weeks it presents to biomicroscopy without alterations, normal retinal mapping, IgG seropositive for Herpes virus, VA left eye: 20/80. After optic coherence tomography of macula and angiofluoresceinography was diagnosed with cystoid macular edema, was initiated aciclovir 500mg, dexamethasone eye drops and acetazolamide 250 mg. During 7 months, there were recurrences in regressing medications, therefore, it was decided to perform an injection of dexamethasone implant. After one month, the patient was without complaints and with VA 20/20 in both eyes, and without taking medications.

Discussão e Conclusões / Discussion

Macular edema secondary to infectious uveitis is a complication that can encompass several etiologies. There are few data in the literature on this type of complication, however this clinical presentation generates a significant visual decrease. Intraocular implants of dexamethasone are widely used in the treatment of macular edema of non-infectious origin. Due to the immunosuppressive effects of the medication, there is a theoretical risk of reactivation of the disease. However, the efficacy and safety of the dexamethasone implant has been verified in several studies. The results were similar to the presented case, generating an improvement in visual acuity and macular thickness. Although reactivation is a rarity, informing patients about possible risks and prophylactic antiviral therapy in high-risk cases is the way to proper medical practice.

Palavras Chave

MACULAR EDEMA, HERPES VIRUS, UVEITIS, DEXAMETHASONE IMPLANT