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R. Cunha, Jr., R. G. Martins, H. Brito, F. Oréfice, W. R. Campos, J. L. Oréfice; Posterior Subtenon Triamcinolone Acetonide Injection as an Adjunctive Treatment in Patients With Recurrent Vogt-Koyanagi-Harada Syndrome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5851.
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To observe if sub-tenon triamcinolone acetonide injection helped to control the ocular inflammation during recurrent stage of the disease and if it was able to reduce systemic corticosteroid and immunosuppressive dosage.
This is a retrospective observational case series study of VKH syndrome in wich sub-tenon triamcinolone acetonide injection was performed in the recurrent stage of VKH in addition to systemic corticosteroid and cytotoxic treatments. It was conducted in the Uveitis Service of Hospital São Geraldo, Federal University of Minas Gerais, Belo Horizonte, Brazil. Data from 6 patients with the diagnosis of Vogt-Koyanagi-Harada syndrome who have received posterior sub-tenon injection of triamcinolone acetonide bilaterally to help in the control of intraocular inflammation was analyzed. All selected patients have received the injection (20mg/0.5mL) by the same surgeon, at recurrent stage of the disease.
As shown in the table 1, 83,3% (n=5) of patients were female. The medium age of the patients was 31 years. All 6 patients had indication for ocular invasive treatment modalities. 50% of the patients (n=3) had related complications of the injection, wich was increase of ocular pressure, that was controlled in all cases with anti-hypertensive topic therapy. Although 50% (n=3) of the patients had recurrence of the disease after subtenon injection, it helped to reduce systemic medication dosage in all cases. The median time with no recurrence after the last injection was 15,8 months.
Sub-tenon injection of triamcinolone acetonide lead to rapid amelioration of severe ocular findings and helped to reduce systemic medication dosage. Further prospective studies are necessary to certify sub-tenon triancinolone acetonide as an adjunctive alternative to help control ocular inflammation and reduce systemic drugs dosage, either corticosteroids or cytotoxic medications.
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