Central Exudative Retinal Detachment: A Rare Complication after Intravitreal Dexamethasone Injection

A 67-year-old pseudophakic diabetic patient was treated for diabetic macular oedema and severe non-proliferative diabetic retinopathy. Macular optical coherence tomography (M-OCT; Heidelberg Spectralis OCT, Heidelberg, Germany) and fluorescence angiography confirmed the diagnosis. A pan-retinal Argon laser coagulation was performed between 2014 and 2015, and the macular oedema was treated with intravitreal injections (IVIs) in both eyes in our outpatient clinic since 2014. The left eye showed little to no improvement after six ranibizumab IVIs. A switch to Aflibercept was conducted, and – after six IVIs – the M-OCT showed no oedema anymore. The therapy could be paused, and the left eye further observed.

The right eye was first treated with 21 Aflibercept IVIs between 2014 and 2020, each time leading to an improvement and a reduction of the central retinal thickness followed by a worsening after 5 to 6 weeks. After 4 years of intravitreal anti-vascular endothelial growth factor treatment, no more macular oedema regression was observed. After careful examination of any potential contraindication and a detailed conversation with the patient, it was decided to switch the therapy to a sustained-release 0.7 mg dexamethasone intravitreal implant (Ozurdex). After each Ozurdex IVI, an improvement of the oedema was seen in the M-OCT. Best-corrected visual acuity (BCVA) initially remained stable at 0.30 logMAR under therapy. Ten weeks after the 6th IVI, the M-OCT examination is shown ([Fig. 1]).

Publication History

Received: 01 April 2022

Accepted: 22 June 2022

Article published online:
09 September 2022

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