PMC6322089_01
Left eye (a) fundus photography showing the presence of peripapillary hemorrhages and papillary edema with dispersed exudates and (b-d) fluorescein angiography showing presence of retinal hemorrhages, with perfusion over the peripheral retina and no visible neovascularization.
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Meditec Inc, Dublin, CA, USA) showed the presence of peripapillary hemorrhages and papillary edema with dispersed exudates (Figure 1(a)). Fluorescein angiography was then performed showing in the left eye a delay in arteriovenous transit time, retinal hemorrhages, vessel wall staining, with perfusion over the peripheral retina and no visible neovascularization (Figure 1(b)).
Left eye optic coherence tomography (a) before and (b) 2 months improvement after dexamethasone intravitreal implant injection and (c) recurrence of macular edema at 3 months post-dexamethasone intravitreal implant.
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Visual acuity gradually improved in the following 2 months from 20/100 to 20/20 with a decrease on central subfield foveal thickness (CSFT) from 608 microm to 319 microm (Figure 2(a) and (b)). At the second month postoperative, the patient presented vision loss and OCT revealed macular edema worsening to 546 microm (Figure 2(c)).
Left eye optic coherence tomography (a) before, (b) 3 months, and (c) 12 months after injection of fluocinolone acetonide intravitreal implant. (a) BCVA: 20/200; CSFT: 578 mum; IOP: 16 mmHg; (b) BCVA: 20/32; CSFT: 397 mum; IOP: 18 mmHg; (c) BCVA: 20/25; CSFT: 392 mum; IOP: 18 mmHg.
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After 12 months, visual acuity improved from 20/200 to 20/25 being stable since the first month after the injection of fluocinolone acetonide IV implant with a progressive decrease in CSFT from 578 microm to 392 microm, without significant changes since month 3 (Figure 3). Despite the good functional and anatomical results observed at the 12th month without additional therapies, it is still possible to observe residual macular edema on the OCT (Figure 3(c)).