A patient in their late sixties with advanced and active birdshot chorioretinopathy who underwent placement of a fluocinolone acetonide, 0.59 mg, intravitreal implant (Retisert; Bausch and Lomb) in their right eye 9 years ago and was receiving prednisone, mycophenolate mofetil, and infliximab-dyyb treatment presented with painless, decreased vision in the right eye. They denied any history of trauma or other ocular symptoms. Best-corrected visual acuity (VA) was 20/500 OD and 20/20 OS, and intraocular pressure (IOP) was 2 mm Hg and 14 mm Hg in the right and left eye, respectively. Examination revealed extrusion of the fluocinolone acetonide intravitreal implant (Figure, A), 2+ anterior-chamber cell,1 1+ vitreous cell,2 and diffuse chorioretinal folds (Figure, B). The patient underwent pars plana vitrectomy with explantation of the implant. Two months later, VA with pinhole improved to 20/50 OD, IOP increased to 11 mm Hg, the anterior-segment and vitreous inflammation had resolved, and chorioretinal folds improved. This case highlights the fact that spontaneous fluocinolone acetonide intravitreal implant extrusion can rarely occur.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Shilpa Kodati, MD, Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, 1000 Wall St, Ann Arbor, MI 48105 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Funding/Support: This case report was supported by the National Institutes of Health intramural research program.
Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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