Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis

Abstract

Purpose To evaluate the effect of orbital floor triamcinolone acetonide (OFTA) injections on inflammation and visual acuity in active non-infectious uveitis. Methods Monocentre, retrospective study in 94 eyes (86 patients) with acute non-infectious uveitis receiving a single OFTA (40 mg) injection. Outcome measures were anterior chamber (AC) and vitreous cell counts, laser flare photometry, best-corrected visual acuity (BCVA), and complications over a 6-month follow-up period. Results The number of patients with X1 þ cells in AC and vitreous was significantly lower after treatment than at baseline (each, Po0.01 at the follow-up examinations). The anti-inflammatory effect lasted for the 6-month follow-up period. Laser flare photometry values were also significantly lower than the baseline levels at 3 (Po0.01) and 6 (P ¼ 0.034) months. BCVA did not differ before and after treatment. Macular oedema was reduced in 27%, unchanged in another 59%, and worse in 14%. Within 6 months, ocular hypertension was observed in up to 8% and progressing cataract was noted in 29%. Conclusions OFTA injections improved AC and vitreous inflammation, but the effect on visual acuity and macular oedema was limited.

Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis

“…If the goal of treatment is highly effective intraocular levels of drug over several weeks and a delay in treatment effect is acceptable, orbital floor injections (20-40 mg) or intraocular injections (2-4 mg) of a crystal suspension of triamcinolone acetonide can be considered to treat uni-or bilateral uveitis associated with dense vitreous body infiltration, hypotony, or macular edema (when topical corticosteroids are not effective) [101][102][103][104] (IIIA). Not enough data are available concerning the efficacy of surgically implanting biodegrable dexamethasone device into the eyes of children with anterior uveitis associated with inflammatory rheumatic diseases (III0).…”

The Effectiveness of Intraocular Methotrexate in the Treatment of Posterior Uveitis in Behçet’s Disease Patients Compared to Retrobulbar Steroids Injection

“…In the present work, the incidence of ocular hypertension was considered the least as compared with other published data following retrobulbar steroid injection, which may be attributed to meticulous patient selection in the present study, as cases with ocular hypertension or previous glaucoma were excluded [18, 21, 25]. …”

“…Moreover, the observed improvement of inflammatory activity may be explained based on previous published data with documented significant improvement of anterior chamber flare and reduced protein accumulation by laser flare photometric studies following orbital floor triamcinolone acetonide injections, as well as the decreased intraocular cytokine levels after intravitreal MTX in cases with refractory inflammatory reactions [20, 21]. …”

Local therapies for inflammatory eye disease in translation: past, present and future

“…Periocular corticosteroid injections can be administered either via the subtenon route or as an orbital floor injection [18]. Both procedures are safe, with a low risk of ocular penetration and of developing other side-effects of corticosteroid administration such as raised intraocular pressure and cataract [23-25]. The duration of effect is approximately 2 months [26].…”