Reactivation of Latent Toxoplasmosis Following Dexamethasone Implant Injection

Daniel J Olson, Ali Torab Parhiz, Robert S Wirthlin
Ophthalmic Surgery, Lasers & Imaging Retina 2016 November 1, 47 (11): 1050-1052
A 74-year-old man presented with right eye pain, swelling, photophobia, and vision loss 1 month following placement of an intravitreal dexamethasone implant (Ozurdex; Allergan, Irvine, CA) for intraocular inflammation refractory to topical therapy. Clinical examination showed visual acuity of 20/400, anterior chamber cell, vitritis, retinal vasculitis, and extensive retinitis. A vitreous biopsy was performed followed by intravitreal injections of vancomycin, ceftazidime, ganciclovir, and clindamycin. Polymerase chain-reaction testing was positive for Toxoplasma gondii. After a course of systemic therapy, intraocular inflammation subsided but visual acuity remained poor. This is the first case to the authors' knowledge of reactivation of T. gondii following intravitreal implantation of dexamethasone. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1050-1052.].

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