Anterior location of intravitreal dexamethasone implant due to kyphosis in a patient with anchlosing spondylitis

The purpose of this report is to report possible effect of patient posture to treatment process in patients receiving dexamethasone intravitreal implant. A 53-year- old man with diagnosis of ankylosing spondylitis followed by rheumatology department, was referred to us for uveitis. Patient had dorsal kyphosis and head bent position leading to his ankylosing spondylitis. Fundus examination showed macular edema in both eyes. Intravitreal administration of dexamethasone implant was performed, afterwards visual acuity increased and anterior chamber reaction reduced in both eyes. However patient complained from shadowing in his right eye. The examination showed that the implant was behind the lens and in pupillary area especially in the right eye. In both eyes, posterior capsular and nuclear cataract were developed. Head-body posture should be considered as a factor for selection of intravitreal drug therapy and also possibly for injection site selection for implants.