Intravitreal Injection of Dexamethasone Implant in Serous Macular Detachment Associated with Waldenström's Disease

Abstract

Purpose: To evaluate the efficacy of one intravitreal injection of dexamethasone (Ozurdex(®); Allergan, Inc., Irvine, Calif., USA) in serous macular detachment (SMD) of one eye, associated with bilateral central retinal vein occlusion (CRVO) in a patient affected by Waldenström's macroglobulinemia (WM).

Patients and methods: A female patient, affected by WM, complained of a progressive decrease in visual acuity, mainly in the left eye (LE). SMD in the LE associated with bilateral CRVO was diagnosed. One intravitreal injection of dexamethasone was administered in the LE and the patient was tested 1, 2, and 6 months after the injection.

Results: 1, 2, and 6 months after the injection, the spectral domain optical coherence tomography (SD-OCT) showed a progressive slight reduction of foveal thickness that was not related to any improvement of visual function.

Conclusions: Treatment with dexamethasone (Ozurdex) induced a progressive slight reduction of SMD but no improvement of visual acuity, and it is possible that this is related to the condition of hematic hyperviscosity that is present in WM.

Keywords: Dexamethasone; Intravitreal injection; Serous macular detachment; Waldenström's macroglobulinemia.

Fig. 1

FAG, infrared reflectance, and SD-OCT of the left eye before treatment (foveal thickness 858 µm).

Fig. 2

SD-OCT of the left eye 1 month after Ozurdex (foveal thickness 686 µm).

Fig. 3

SD-OCT of the left eye 2 months (upper panel) and 6 months (lower panel) after Ozurdex (foveal thickness 680 µm and 547 µm, respectively).