Intravitreal dexamethasone implant for refractory stromal choroiditis in birdshot retinochoroiditis: efficacy and therapeutic implications

This retrospective, single-centre observational study evaluated the efficacy of intravitreal dexamethasone implant in the management of stromal choroiditis in Birdshot retinochoroiditis refractory to systemic immunosuppression. Four patients with bilateral stromal choroiditis unresponsive to systemic treatment received bilateral dexamethasone implant. Therapeutic response was assessed using indocyanine green angiography, demonstrating resolution of hypofluorescent dots, corresponding to active stromal choroidal lesions, in all cases.While intravitreal dexamethasone is not recommended as monotherapy for this chronic condition requiring long-term systemic immunosuppression, it proved to be effective in cases of refractory stromal involvement, particularly when systemic corticosteroids are contraindicated or during periods of therapeutic transition.