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J. M. Kim, D. Callanan, D. F. Martin, S. Srivastava; Clinical Outcomes Intravitreal and Peri-Ocular Steroid Injections in Misdiagnosed Infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5889.
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To evaluate the clinical outcomes of patients treated with intravitreal or peri-ocular steroid injections initially diagnosed with non-infectious inflammatory uveitis that were subsequently diagnosed with infectious uveitis.
A retrospective case series of patients who were referred after the diagnosis of non-infectious inflammation was made and either posterior sub-tenons or intravitreal corticosteroid injection was administered. Initial visual acuity prior to steroid injection, visual acuity after injection and at presentation, complications from treatment, and laboratory work up prior to and after steroid injections were reviewed.
A total of seven eyes of seven patients were identified. Visual acuities prior to administration of posterior sub-tenons or intravitreal triamcinolone acetonide ranged from 20/30 to count fingers vision. Visual acuities after administration ranged from 20/50 to light perception. Initial diagnoses included sarcoidosis, acute zonal occult outer retinopathy, chronic iridocyclitis, and granulomatous panuveitis. Four patients were later diagnosed with toxoplasmosis, two with acute retinal necrosis and one with syphilis. 6 patients had final visual acuity of CF or worse. One patient had 20/50 vision at last follow-up.
Patients with infectious uveitis who were initially treated with either intravitreal or periocular injections of steroids have poor visual outcomes. Caution is recommended in the use of steroid injections in patients with presumed non-infectious uveitis.
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