Author Affiliations: Cole Eye Institute, The Cleveland Clinic, Ohio (Dr Lowder); Federal University of São Paulo, Brazil (Prof Belfort); Clinical Ophthalmology, Moorfields Eye Hospital, London, England (Dr Lightman); Massachusetts Eye Research and Surgery, Institution and Ocular Immunology and Uveitis Foundation, Cambridge (Dr Foster); and Allergan, Irvine, California (Drs Robinson, Schiffman, Li, Hollander, Hashad, and Whitcup and Mr Cui).
Dr Saraiya and colleagues describe a patient with bilateral idiopathic chronic iridocyclitis with multifocal choroiditis and persistent cystoid macular edema despite maximally tolerated systemic immunosuppression. In addition, the patient, a known “steroid responder,” was being treated with topical prednisone acetate ophthalmic suspension (Pred Forte; Allergan, Irvine, California) twice daily and topical brimonidine tartrate–timolol maleate twice daily in both eyes. The patient received dexamethasone intravitreal implants (Ozurdex; Allergan, Irvine, California) in the left eye and then in the right eye 3 weeks later, with rapid resolution of cystoid macular edema. Within 2 months after the initial injection, the patient developed elevated intraocular pressure (IOP) in both eyes that continues despite receiving 4 topical IOP-lowering medications and oral methazolamide.
Lowder C, Belfort R, Lightman S, Foster CS, Robinson MR, Schiffman RM, Li X, Cui H, Hollander DA, Hashad Y, Whitcup SM. A Report of High Intraocular Pressure With the Dexamethasone Intravitreal Implant—Reply. Arch Ophthalmol. 2011;129(12):1638-1640. doi:10.1001/archophthalmol.2011.356