Intravitreal fluocinolone acetonide (ILUVIEN) implant for the treatment of refractory cystoid macular oedema after retinal detachment repair

ABSTRACT
Introduction
Cystoid Macular Oedema (CMO) is one of the most frequent postoperative macular complication to cause partial visual recovery after successful retinal detachment (RD) repair. Refractory CMO is difficult to treat and many strategies have been employed with varying degrees of success. We report for the first time the use of ILUVIEN implant to treat refractory CMO after successful RD repair.
Case description
A 65-year-old female presented with right eye (RE) full thickness macular hole, she underwent RE pars plana vitrectomy, internal limiting membrane (ILM) peeling, cryotherapy with gas C3F8 12% tamponade. After that she developed RE macula-on retinal detachment and proliferative vitreoretinopathy (PVR) and she required more than one procedure for successful retinal reattachment. Later, she developed CMO that responded to intravitreal triamcinolone injections and intravitreal dexamethasone 0.7-mg implants but recurrence of CMO was a real problem. When she received ILUVIEN intravitreal implant her visual acuity improved and CMO resolved without recurrence for 13 months.
Conclusions
Refractory CMO after RD repair is difficult to treat and in a quarter of cases it will not improve without treatment. Our case shows that a single ILUVIEN implant maintained anatomical dry fovea and improved vision. This also demonstrates that ILUVIEN is an effective management strategy to reduce the need of repeated treatments.