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. 2024 May 3;14(1):19.
doi: 10.1186/s12348-024-00397-y.

Fluocinolone intravitreal implant (Iluvien) for macular edema secondary to immune recovery uveitis in patient with acute myeloid leukemia

J M Cachero Rodríguez  1   2 , J Artaraz  3 , Nora Imaz  4 , A Fonollosa  3   5
Affiliations

Fluocinolone intravitreal implant (Iluvien) for macular edema secondary to immune recovery uveitis in patient with acute myeloid leukemia

J M Cachero Rodríguez et al. J Ophthalmic Inflamm Infect. .

Abstract

Purpose: To report the use of Fluocinolone intravitreal implant (Iluvien) for the treatment of persistent cystoid macular edema (CME) due to immune recovery uveitis syndrome in a patient with previous cytomegalovirus retinitis and acute myeloid leukemia.

Design: Case report.

Methods: The clinical history of a patient who received an Iluvien implant in one eye for the treatment of cystoid macular edema due to immune recovery uveitis syndrome, previously treated with peribulbar Triamcinolone and intravitreal Dexamethasone injections, was reviewed.

Results: A 48-year-old woman presented with cystoid macular edema due to immune recovery uveitis syndrome. The patient had a history of cytomegalovirus retinitis 3.5 years prior, secondary to immunosuppressive treatment for an acute myeloid leukemia. Three periocular triamcinolone injections and two dexamethasone intravitreal implants were performed, but the edema recurred, so fluocinolone intravitreal implant was used, achieving a sustained control of the condition at one year of follow-up.

Conclusion: The Fluocinolone intravitreal implant may be an effective treatment for persistent CME in patients with immune recovery uveitis syndrome.

Keywords: Cystoid macular edema; Cytomegalovirus retinitis; Fluocinolone intravitreal implant; Immune recovery uveitis; Uveitis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Funduscopy of LE showing inferior hemorrhagic retinitis, suggestive of CMV infection
Fig. 2
Fig. 2
Imaging at IRU syndrome diagnosis. A: OCT showing CME. B: Retinography showing an area of preretinal fibrosis where retinitis was previously present
Fig. 3
Fig. 3
A: CME before treatment with Dexamethasone intravitreal implant; B: Resolution of the edema after treatment
Fig. 4
Fig. 4
OCT showing recurrence of CME after second injection of Dexamethasone intravitreal implant
Fig. 5
Fig. 5
OCT imaging during follow-up after Iluvien implant, A: 2 months after treatment, B: 1 year after treatment
See this image and copyright information in PMC

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