Purpose:
To evaluate if Sub-Tenon triamcinolone is an effective adjunctive therapy to reduce the systemic drug burden for nonnecrotizing anterior scleritis.
Methods:
This study is a retrospective analysis of 12 patients (17 eyes) at one institution receiving sub-Tenon triamcinolone injections for nonnecrotizing scleritis from 2008 to 2011. Primary outcome measures included systemic drug burden and scleritis grade, and secondary outcomes included subjective improvement in symptoms. Adverse events including elevation in intraocular pressure, cataract, or scleral thinning were monitored.
Results:
Twelve patients (17 eyes) were included in the study. The mean age was 54 years old with 11 females and 1 male. All patients were receiving systemic therapy, and 6 patients had associated systemic autoimmune disease. Follow-up averaged 14 months (ranged 6 to 28 months). All patients experienced improvement in symptoms. Two patients had an intraocular pressure response controlled with medication, and two patients underwent cataract surgery. No patient experienced scleral melting resulting from the injections. The mean number of systemic drugs utilized in theses patients remained constant or decreased as validated by the Wilcoxon signed-rank test.
Conclusions:
Sub-Tenon triamcinolone injections may be an option to reduce the burden of systemic immunosuppression in patients with nonnecrotizing scleritis. This may be especially useful in patients with co-morbidities where the hazards of aggressive immunosuppression may occasionally outweigh benefits.
Keywords: uveitis-clinical/animal model • inflammation • anterior segment