Mild toxic anterior segment syndrome (TASS) developed after Sustained-release Dexamethasone Intravitreal Implant, during the early post-implantation period. Prompt treatment started with topical antibiotics and steroid eye drop after subconjunctival injection. The signs and symptoms of inflammation were resolved with total remission on post-implantation day 10. To the best of our knowledge, the presented case is the first report with TASS following sustained-release dexamethasone intravitreal implant.

Keywords: Toxic Anterior Segment Syndrome; Dexamethasone Intravitreal Implant; Ozurdex; Inflammation

References

1. Boyer DS., et al. “Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema”. Ophthalmology10 (2014): 1904-1914.
2. Mayer WJ., et al. “Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema”. Ophthalmologica2 (2012): 110-116.
3. Madi HA., et al. “Corneal graft failure due to migration of Ozurdex™ implant into the anterior chamber”. The American Journal of Ophthalmology Case Reports 8 (2017): 25-27.
4. Noma H., et al. “Aqueous flare and inflammatory factors in macular edema with central retinal vein occlusion: a case series”. BMC Ophthalmology 11 (2013): 13-78.
5. Michalska-Małecka K., et al. “Evaluation of the effectiveness and safety of glucocorticoids intravitreal implant therapy in macular edema due to retinal vein occlusion”. Clinical Interventions in Aging 11 (2016): 699-705.
6. Marchino T., et al. “Acute-onset endophthalmitis caused by alloiococcus otitidis following a dexamethasone intravitreal implant”. Case Reports in Ophthalmology 4 (2013): 37-41.
7. Park CY., et al. “Toxic anterior segment syndrome-an updated review”. BMC Ophthalmology 18 (2018): 276.
8. Bodnar Z., et al. “Toxic anterior segment syndrome: update on the most common causes”. Journal of Cataract and Refractive Surgery11 (2012): 1902-1910.
9. Sevimli N., et al. “Toxic anterior segment syndrome following deep anterior lamellar keratoplasty”. The Arquivos Brasileiros de Oftalmologia 5 (2016): 330-332.
10. Moisseiev E and Barak A. “Toxic anterior segment syndrome outbreak after vitrectomy and silicone oil injection”. The European Journal of Ophthalmology 5 (2012): 803-807.
11. Andonegui J., et al. “Outbreak of toxic anterior segment syndrome after vitreous surgery”. Archivos de la Sociedad Espanola de Oftalmologia 8 (2009): 403-405.
12. Sorenson AL., et al. “Toxic anterior segment syndrome caused by autoclave reservoir wall biofilms and their residual toxins”. Journal of Cataract and Refractive Surgery 11 (2016): 1602-1614.
13. Bielory BP., et al. “Toxic anterior segment syndrome: inadvertent Administration of Intracameral Lidocaine 1% and phenylephrine 2.5% preserved with 10% Benzalkonium chloride during cataract surgery”. Cornea 36 (2017): 621-624.
14. Cakir B., et al. “Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracameral use of cefuroxime”. Clinical Ophthalmology 9 (2015): 493-497.
15. Litwin AS and Pimenides D. “Toxic anterior segment syndrome after cataract surgery secondary to subconjunctival gentamicin”. Journal of Cataract and Refractive Surgery 12 (2012): 2196-2197.
16. Altintas AK., et al. “Toxic anterior segment syndrome outbreak after cataract surgery triggered by viscoelastic substance”. Middle East African Journal of Ophthalmology 1 (2017): 43-47.
17. Matsou A., et al. “Generic trypan blue as possible cause of a cluster of toxic anterior segment syndrome cases after uneventful cataract surgery”. Journal of Cataract and Refractive Surgery 6 (2017): 848-852.
18. Lee SN. “Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery”. Indian Journal of Ophthalmology 8 (2014): 890-892.
19. Sorkin N., et al. “Evaluation of the retinal, choroidal, and nerve fiber layer thickness changes in patients with toxic anterior segment syndrome Graefes”. Archive for Clinical and Experimental Ophthalmology 3 (2015): 467-475.
20. Marchino T., et al. “Acute-onset endophthalmitis caused by alloiococcus otitidis following a dexamethasone intravitreal implant”. Case Reports in Ophthalmology 4 (2013): 37-41.
21. Suzuki T., et al. “Outbreak of late-onset toxic anterior segment syndrome after implantation of one-piece intraocular lenses”. American Journal of Ophthalmology 5 (2015): 934-939.
22. Oshika T., et al. “Outbreak of subacute-onset toxic anterior segment syndrome associated with single-piece acrylic intraocular lenses”. Ophthalmology 124 (2017): 519-523.

Citation

Citation: Ayse Gul Kocak Altintas and Mine Turkay. “Mild Toxic Anterior Segment Syndrome Following Intravitreal Injection of Dexamethasone Implant”. Acta Scientific Ophthalmology 3.6 (2020): 05-09.

Copyright

Copyright: © 2020 Ayse Gul Kocak Altintas and Mine Turkay. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.