Infectious Scleritis after Subtenon Triamcinolone Acetonide Injection

Gharaee, Hamid; Khalifé, Mohamad; Poor, Setareh Sagheb Hossein; Abrishami, Mojtaba

doi:10.3109/09273948.2011.584010

Cited by 18 publications

(14 citation statements)

References 4 publications

(3 reference statements)

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“…Subtenon injections have been reported as the cause of infectious scleritis [9,10,11], but our patient had symptoms and signs of scleral inflammation more than a month before the injection. Furthermore, the patient's first ophthalmologist could not recall using any compounded steroid on the patient.…”

Section: Discussionmentioning

confidence: 81%

Occult Fungal Scleritis

et al. 2016

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Purpose: To heighten awareness of occult fungal scleritis. Method: Case report and review of the literature. Results: A 73-year-old woman with diabetes mellitus was diagnosed for 3 months with immune-mediated scleritis and subsequently treated with corticosteroids. On referral, the patient had a scleral nodule with contiguous corneal infiltrate and hypopyon. Culture grew Fusarium species not further classified. The infection could not be controlled with antifungal therapy, and the eye was removed. No exogenous or endogenous source for the infection could be identified by clinical history or examination. Conclusion: Fungal scleritis can develop in persons without a history of foreign body injury, minor trauma, or evidence of endogenous fungemia. A high index of suspicion for infectious scleritis must be maintained in persons with presumed immune-mediated scleritis who fail to respond to conventional therapy, particularly if they present with decreased visual acuity.

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Section: Discussionmentioning

confidence: 81%

Occult Fungal Scleritis

et al. 2016

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“…Although 14 eyes (2.9%) developed an increased IOP, none of the cases developed scleral necrosis or melt [ 4 ]. A few cases of infectious scleritis or endophthalmitis after STI have been reported [ 6 , 7 ]. Although our patient did not show keratitis while receiving systemic steroids and steroid eye drops, STI can reactivate HSV and trigger severe herpetic keratitis.…”

Section: Discussionmentioning

confidence: 99%

“…Subconjunctival triamcinolone acetonide injection (STI) is used to treat anterior scleritis and uveitis [ 2 , 3 , 4 , 5 ]. The reported adverse events of STI are elevated intraocular pressure (IOP), cataract formation or progression, subconjunctival hemorrhage, scleral necrosis, scleral perforation, infectious scleritis, and endophthalmitis [ 4 , 6 , 7 ]. We report a case of herpetic epithelial keratitis after STI for hypotony caused by scleritis and anterior uveitis.…”

Section: Introductionmentioning

confidence: 99%

A Case of Herpetic Keratitis after Subconjunctival Triamcinolone Acetonide Injection

Inoue

Suzuki

Joko

et al. 2014

Case Rep Ophthalmol

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Purpose: We report a case of herpetic epithelial keratitis that developed after subconjunctival triamcinolone acetonide injection (STI). Methods: A 65-year-old female with anterior uveitis and hypotony in her right eye was given a STI (2 mg/0.5 ml). After the injection, she developed redness and an ocular discharge. A clinical examination was performed and real-time polymerase chain reaction (PCR) was used to amplify the viral DNA in a corneal scraping. Results: Slit-lamp biomicroscopy revealed a severe purulent discharge, conjunctival injection, and a geographic corneal ulcer in the right eye. Herpes simplex virus 1 DNA was identified in the corneal scraping using real-time PCR. Herpetic keratitis was diagnosed and topical acyclovir ointment as well as systemic valacyclovir were started. The inflammation subsided with this medication. Conclusion: We encountered a case of herpetic epithelial keratitis after a STI.

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“…These retinal surgeries have additionally been associated with Pseudomonas , methicillin-resistant Staphylococcus aureus , and coagulase-negative Staphylococcus albus 3,17. The use of sub-Tenon’s triamcinolone acetonide injection has also been associated with the development of infectious scleritis in two cases, which were culture positive for Staphylococcus epidermidis and Nocardia 18,19…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and visual outcomes in infectious scleritis: a review

Ramenaden¹,

Raiji²

2013

OPTH

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Infection is a very important but rare cause of scleritis, occurring in about 5%–10% of all patients presenting with scleral inflammation. However, due to the similarity of its presentation, infectious scleritis is often initially managed as autoimmune, potentially further worsening its outcome. The overall visual outcome in infectious scleritis is generally worse than its autoimmune counterparts, perhaps because of the delay in diagnosis or because of the aggressive nature of associated microbes. Thus, there is a definite need for insight into the diagnostic approach and treatment options for this ocular disease process. Several studies and case reports have been published in recent years that have provided useful information regarding the presenting clinical features and etiologic microbial agents in infectious scleritis. This review summarizes the important findings in the literature that may aid in differentiating infectious scleritis from other etiologies, including predisposing factors, microbe-specific characteristics, diagnostic tools, treatment modalities, and outcomes.

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Infectious Scleritis after Subtenon Triamcinolone Acetonide Injection

Cited by 18 publications

References 4 publications

Occult Fungal Scleritis

Occult Fungal Scleritis

A Case of Herpetic Keratitis after Subconjunctival Triamcinolone Acetonide Injection

Clinical characteristics and visual outcomes in infectious scleritis: a review

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