Postintravitreal Dexamethasone Implant (OZURDEX®) – Induced Ocular Hypotony in Patients with Rheumatological Disease: A Rare Complication

Abstract

Dexamethasone intravitreal implant (OZURDEX ^® ) is widely used in the management of inflammatory and edematous ocular conditions, including those associated with systemic rheumatological diseases. While generally considered safe, rare complications such as ocular hypotony have been reported, particularly in eyes with underlying structural and inflammatory vulnerability. We report two cases of young females with a history of rheumatological disease who developed hypotony after being treated with OZURDEX ^® for recurrent macular edema. Both patients showed reduced intraocular pressure within 48 h postinjection without any structural complications or evidence of wound leak and recovered spontaneously without any active intervention. Patients with inflammatory or rheumatological conditions may have increased susceptibility to postinjection hypotony. These cases show the significance of cautious patient selection, preprocedural assessment, and close postinjection monitoring to reduce risk and assure positive outcomes.