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Persistent vitreous hemorrhage after intravitreal injection of dexamethasone intravitreal implant in patients with diabetic macular edema

1 Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
2 Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung; School of Medicine, National Yang-Ming University, Taipei, Taiwan

Correspondence Address:
Shwu-Jiuan Sheu,
Department of Ophthalmology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung 813
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_87_17

We report three cases of persistent vitreous hemorrhage after injection of a biodegradable 0.7 mg dexamethasone intravitreal implant (Ozurdex, Allergan), (DEX) to treat and manage diabetic macular edema (DME); we also summarize available case reports and review the literature regarding persistent vitreous hemorrhage. All three patients underwent pars plana vitrectomy due to nonclearing vitreous hemorrhage after conservative treatment for 2–3 months. During operation, we noted the presence of neovascular membrane along the vascular arcade with taut posterior hyaloid; however, no posterior vitreous detachment (PVD) was found in any of three patients. The implants were carefully preserved, so were the effects in reducing macular edema. Persistent vitreous hemorrhage after DEX injection was rare but manageable without interrupting the effect on DME. Eyes with neovascular membrane but without PVD may be at risk of developing vitreous hemorrhage after DEX injection.

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