Subconjunctival triamcinolone treatment for non-necrotising anterior scleritis

Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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“…Sub‐conjunctival TA may be given for the treatment of non‐necrotising, non‐infectious anterior scleritis …”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…The largest series reported to date is from Albini and Zamir, who treated 38 eyes of 35 patients and found 96% had complete resolute of scleritis with average time to recurrence as 116 months 18. Roufas et al reported their experience of treating 12 patients who had failed systemic treatment with 25 subconjunctival triamcinolone injections 17. Complete resolution of symptoms and signs of scleral inflammation occurred after 23 of the 25 injections administered.…”

Section: Treatmentmentioning

confidence: 99%

Scleritis: presentations, disease associations and management

Sims¹

2012

Postgraduate Medical Journal

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Scleritis is a serious inflammatory condition that is often painful, and in severe cases can result in permanent loss of vision. Approximately half the patients affected have no identifiable cause, but 30%-40% have an underlying systemic autoimmune condition. Scleritis may be the initial manifestation of Wegener's granulomatosis or rheumatoid arthritis, and all patients with scleritis require a thorough systemic evaluation. Scleritis has a variable presentation and disease course, and may be an acute monophasic illness, a relapsing remitting process, or take a chronic course. Treatment options include local therapy with subconjunctival steroid injections for non-necrotising scleritis, and systemic anti-inflammatory or immunosuppressive therapy. Biologic agents have been used with success in some refractory cases. Ocular and systemic morbidity is reduced by timely treatment with immunosuppressant medications.

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“…SCTA/subtenons triamcinalone (STA) have been used previously for a variety of conditions including anterior scleritis [2], diabetic macular oedema [3] and following cataract surgery [4]. However, to our knowledge, its use for treating post-blebitis CMO has not been previously described.…”

Section: Commentmentioning

confidence: 99%

“…However, to our knowledge, its use for treating post-blebitis CMO has not been previously described. SCTA/STA side-effects such as scleral necrosis, scleral perforation, conjunctival ulceration, raised intraocular pressure (IOP) and cataract formation are rare [2]. Injecting triamcinolone subconjunctivally has significant advantages compared with intravitreal administration.…”

Section: Commentmentioning

confidence: 99%