Resolution of Macular Edema secondary to rituximab after intravitreal dexamethasone: A case report and a review of the literature

Eur J Ophthalmol. 2024 Mar;34(2):NP52-NP55. doi: 10.1177/11206721231199120. Epub 2023 Aug 29.

Abstract

Purpose: to report a case of bilateral macular edema (ME) secondary to Rituximab infusions in a woman affected by IgG4-Related Disease and to review of prior cases of ME related to Rituximab.

Observations: ME completely resolved after Intravitreal Dexamethasone Implant (IDI).

Conclusions and importance: ME is a rare complication after Rituximab infusions and very few cases are reported in the literature. Usually, ME occurs a few weeks after systemic administration and is probably related to a local release of cytokines. It resolves with oral, subtenon or intravitreal steroids. Our case is the first showing that IDI is a safe and effective treatment in ME secondary to Rituximab. Rituximab is not required to be discontinued if treatment for ME is started.

Keywords: IgG4 related disease (IgG4-RD); Macular Edema; rituximab.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Dexamethasone
  • Drug Implants / adverse effects
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Retinal Vein Occlusion* / complications
  • Rituximab / adverse effects

Substances

  • Dexamethasone
  • Rituximab
  • Drug Implants
  • Glucocorticoids