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KMID : 1151620160010010051
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Journal of Retina
2016 Volume.1 No. 1 p.51 ~ p.54
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Recurrent Cystoid Macular Edema Associated with Neurotrophic Keratitis
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Moon In-Hee
Kim Min
Lee Hyung-Keun
Beyun Sek-Ho
Kim Sung-Soo
Koh Hyoung-Jun
Lee Sung-Chul
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Abstract
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Purpose: To report a case of recurrent cystoid macular edema (CME) in a patient with neurotrophic keratitis
Case summary: A 46-year-old woman presented with low vision in her right eye one month after undergoing a neurosurgical operation for removal of a clivus chordoma. Slit lamp examination of her right eye showed lagopthalmos, epithelial defects, stromal infiltration and absence of corneal sensation. She was diagnosed with neurotrophic keratitis and cataracts in her right eye and proceeded to receive cataract surgery. After 9 months post-surgery, she underwent fundus examination, optical coherence tomography and fluorescence angiography which revealed CME with a central macular thickness of 800 μm. She received two consecutive monthly intravitreal bevacizumab injections, however macular edema persisted. As an alternative treatment, an intravitreal dexamethasone implant was injected and after 1 month, macular edema was completely resolved with a macular thickness of 282 μm. Because the patient’s recurrent macular edema had lasted for 5 months, intravitreal dexamethasone implant injections were performed twice.
Conclusions: This is the first case report of CME following treatment of neurotrophic keratitis after cataract surgery. The degree of inflammation in this case may have been greater than most post-cataract cases, and this chronic inflammatory state in the cornea may have led to the development of CME. In order to recognize this potential complication earlier, careful examination of both the cornea and posterior segment is needed in patients who are affected by persistent corneal inflammation such as neurotrophic keratitis. Additionally, intravitreal dexamethasone implant injections could be helpful for recurrent CME.
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KEYWORD
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Cystoid macular edema, Intravitreous dexamethasone implant injection, Neurotrophic keratitis, Postoperative complications
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