Subconjunctival dexamethasone implant (Ozurdex) for peripheral ulcerative keratitis

Area of Science:

• Ophthalmology
• Immunology

Background:

• Peripheral ulcerative keratitis (PUK) is a severe inflammatory condition affecting the cornea.
• Systemic immunosuppressive therapy is a common treatment for PUK, but can cause adverse events.

Observation:

• An 82-year-old female with recurrent PUK in the right eye, unresponsive to systemic steroids and methotrexate.
• The patient experienced adverse events necessitating discontinuation of systemic therapy.
• Subconjunctival dexamethasone implant injections were administered after PUK recurrence.

Findings:

• Three subconjunctival dexamethasone implant injections over 10 months led to complete resolution of PUK.
• No scleral melt or ocular hypertension was observed 11 months post-injection.
• The treatment was well-tolerated by the patient.

Implications:

• Subconjunctival dexamethasone implants represent a viable and safe treatment option for PUK, particularly in cases of recurrence or intolerance to systemic therapy.
• This approach may help preserve vision and reduce the need for more invasive treatments in complex PUK cases.