Reactivation of Latent Toxoplasmosis Following Dexamethasone Implant Injection

A 74-year-old man presented with right eye pain, swelling, photophobia, and vision loss 1 month following placement of an intravitreal dexamethasone implant (Ozurdex; Allergan, Irvine, CA) for intraocular inflammation refractory to topical therapy. Clinical examination showed visual acuity of 20/400...

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Bibliographic Details
Published inOphthalmic surgery, lasers & imaging Vol. 47; no. 11; pp. 1050 - 1052
Main Authors Olson, Daniel J, Parhiz, Ali Torab, Wirthlin, Robert S
Format Journal Article
LanguageEnglish
Published United States SLACK INCORPORATED 01.11.2016
Subjects
Aged
Dexamethasone - adverse effects
Drug Implants - adverse effects
Eyes & eyesight
Glucocorticoids - adverse effects
Humans
Injections
Intravitreal Injections - adverse effects
Macular Edema - drug therapy
Male
Pain management
Toxoplasmosis - etiology
Transplants & implants
Uveitis - drug therapy
Virus Activation
Virus Latency
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Summary:A 74-year-old man presented with right eye pain, swelling, photophobia, and vision loss 1 month following placement of an intravitreal dexamethasone implant (Ozurdex; Allergan, Irvine, CA) for intraocular inflammation refractory to topical therapy. Clinical examination showed visual acuity of 20/400, anterior chamber cell, vitritis, retinal vasculitis, and extensive retinitis. A vitreous biopsy was performed followed by intravitreal injections of vancomycin, ceftazidime, ganciclovir, and clindamycin. Polymerase chain-reaction testing was positive for Toxoplasma gondii. After a course of systemic therapy, intraocular inflammation subsided but visual acuity remained poor. This is the first case to the authors' knowledge of reactivation of T. gondii following intravitreal implantation of dexamethasone. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1050-1052.].
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ISSN:2325-8160
2325-8179
DOI:10.3928/23258160-20161031-10