Use of intravitreal steroids in the clinic

A 73 year old female was diagnosed with bilateral anterior and intermediate uveitis due to sarcoidosis on 2014. During the follow up posterior sub-capsular and nuclear cataract developed in the right eye (RE) with deterioration of VA. On ophthalmological examination of the RE, her best-corrected visual acuity (BCVA) was 6/30 and Intraocular pressure (IOP) measured 13 mm Hg. Slit-lamp biomicroscopy revealed a clear cornea, clear anterior chamber without cells and moderate nuclear sclerosis and diffuse posterior sub- capsular cataract. Posterior segment examination demonstrated few vitreous cells without haze and macular ERM without CME or retinal lesions.

Dexamethasone, a potent corticosteroid, has been shown to suppress inflammation by inhibiting oedema, fibrin deposition, capillary leakage, and phagocytic migration of the inflammatory response. Vascular Endothelial Growth Factor (VEGF) is a cytokine which is expressed at increased concentrations in the setting of macular oedema. It is a potent promoter of vascular permeability. Corticosteroids have been shown to inhibit the expression of VEGF. Additionally, corticosteroids prevent the release of prostaglandins, some of which have been identified as mediators of cystoid macular oedema.

Median visual acuity 1 day after surgery was 20/40 (range 20/20 to counting fingers). At final follow-up (mean months; range 7 to 41 months), 17 eyes (%) eyes achieved visual acuity of 20/40 or better; 2 eyes failed to achieve a final visual acuity of 20/40 or better, 1 as a result of optic atrophy and the other as a result of macular edema. No patient lost acuity and no eye developed macular edema within 4 months of surgery. Intraocular pressure elevation occurred after surgery in 3 eyes; all were controlled by topical medication that was discontinued after 3 months. One patient developed severe intraocular inflammation after surgery that resolved with intensive topical corticosteroid therapy within 1 week.

B. cereus  has been recently recognized as a primary pathogen of ocular infections ( 12 , 40 ). Endophthalmitis is a serious illness that can result in visual compromise within 12-48 hours after inoculation ( 17 ,  33 ). Early diagnosis is important to achieve successful treatment. A high index of suspicion is important in the setting of a patient who presents with ocular infection after trauma or in the setting of drug abuse. Prompt recognition of the infection should allow initiation of appropriate therapy before permanent structural changes occur ( 27 ). In patients with post-traumatic endophthalmitis caused by  B.   cereus , if managed aggressively outcome maybe associated with preservation of anatomic integrity and restoration of useful visual acuity. ( 6 ,  13 )  

Use of intravitreal steroids in the clinic

use of intravitreal steroids in the clinic

B. cereus  has been recently recognized as a primary pathogen of ocular infections ( 12 , 40 ). Endophthalmitis is a serious illness that can result in visual compromise within 12-48 hours after inoculation ( 17 ,  33 ). Early diagnosis is important to achieve successful treatment. A high index of suspicion is important in the setting of a patient who presents with ocular infection after trauma or in the setting of drug abuse. Prompt recognition of the infection should allow initiation of appropriate therapy before permanent structural changes occur ( 27 ). In patients with post-traumatic endophthalmitis caused by  B.   cereus , if managed aggressively outcome maybe associated with preservation of anatomic integrity and restoration of useful visual acuity. ( 6 ,  13 )  

Media:

use of intravitreal steroids in the clinicuse of intravitreal steroids in the clinicuse of intravitreal steroids in the clinicuse of intravitreal steroids in the clinicuse of intravitreal steroids in the clinic

http://buy-steroids.org