Fulminant Toxoplasmic Chorioretinitis Following Intravitreal Dexamethasone Implantation
10.3341/jkos.2019.60.9.896
- Author:
Areum JEONG
1
;
Dong Geun PARK
;
Min SAGONG
Author Information
1. Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. msagong@ynu.ac.kr
- Publication Type:Case Report
- Keywords:
Dexamethasone implant;
Intravitreal injection;
Toxoplasma gondii;
Toxoplasmic chorioretinitis;
Toxoplasmosis
- MeSH:
Anti-Bacterial Agents;
Blood Cell Count;
Chemistry;
Chorioretinitis;
Dexamethasone;
Diagnosis;
Female;
Follow-Up Studies;
Humans;
Inflammation;
Intravitreal Injections;
Middle Aged;
Polymerase Chain Reaction;
Prednisolone;
Retinitis;
Toxoplasma;
Toxoplasmosis;
Visual Acuity;
Vitrectomy
- From:Journal of the Korean Ophthalmological Society
2019;60(9):896-900
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of fulminant toxoplasmic chorioretinitis following intravitreal dexamethasone implantation monotherapy in a stabilized toxoplasmic chorioretinitis patient with initial treatment. CASE SUMMARY: A 60-year-old healthy female presented with decreased visual acuity in the left eye. On fundus examination, focal chorioretinitis and yellow-white infiltration were observed. Laboratory work-up, including blood chemistry, complete blood count, and serum serology, was negative; however, toxoplasmic chorioretinitis could not be ruled out. The primary lesion improved with antibiotics and prednisolone treatment. However, the patient did not come in for her follow-up visit, as she had already received an intravitreal dexamethasone implant for recurrent vitreous inflammation elsewhere. On her return, she presented with necrotic retinitis with extensive infiltration. She underwent diagnostic vitrectomy and implant removal. A diagnosis of toxoplasma antigen was confirmed by polymerase chain reaction analysis; the lesions stabilized after anti-toxoplasmic therapy. CONCLUSIONS: Intravitreal dexamethasone implant monotherapy with stabilized toxoplasmic chorioretinitis without systemic antibiotics can lead to fulminant toxoplasmic chorioretinitis and should be used with caution.
