Periocular corticosteroid injection in the management of uveitis in children.

Abstract

PURPOSE:

To report the outcome of orbital floor corticosteroid injection (OFCI) in the management of uveitis in children.

METHODS:

  A retrospective noncomparative interventional case series. The medical records of 15 consecutive children (19 eyes) with various forms of uveitis treated with OFCI of 40 mg/ml methylprednisolone acetate or a combination of 20 mg/0.5 ml Triamcinolone and 2 mg/0.5 ml dexamethasone were reviewed. Data were collected 6 months postinjection and included details of uveitis, best corrected visual acuity (BCVA), ocular inflammation, systemic therapy required and potential complications of OFCI.

RESULTS:

The mean BCVA improvement was 0.18 logarithm of the minimum angle of resolution (p < 0.001), at a mean of 6 weeks (range, 4-20). Fourteen eyes (74%) had significant improvement in inflammation, 4-7 weeks post-OFCI, with a median of 4 weeks. Anterior uveitis was treated effectively in all eyes, vitritis resolved in all but one case and resolution of cystoid macular oedema was achieved in six eyes (55%). Uveitis relapsed in seven eyes (50%) after a median time of 4 months (range, 2-5 months). Four eyes (21%) underwent more than one injection. The dosage of immunosuppressive systemic therapy was reduced or able to be stopped in three patients (50%). Steroid-induced cataract was observed in four eyes (21%), 5 months post-OFCI. One patient developed cushingoid features 6 weeks post his second OFCI.

CONCLUSION:

Corticosteroid orbital floor injections resulted in control of active uveitis and visual acuity improvement in most children. However, the effect might be transient and induce cataract formation.

• Authors: Zohar Habot-Wilner, Ahmed Sallam, Athena Roufas, Paul Mb Kabasele, John R Grigg, Peter McCluskey, Sue Lightman
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 88 Issue 8 Pg. e299-304 (Dec 2010) ISSN: 1755-3768 [Electronic] England
• PMID: 21114631 (Publication Type: Journal Article)
• Copyright: © 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.

Chemical References

• Glucocorticoids
• Methylprednisolone Acetate
• Dexamethasone
• Triamcinolone Acetonide
• Methylprednisolone

Topics

• Adolescent
• Cataract (chemically induced)
• Cataract Extraction
• Child
• Child, Preschool
• Dexamethasone (administration & dosage, adverse effects)
• Drug Therapy, Combination
• Female
• Glucocorticoids (administration & dosage, adverse effects)
• Humans
• Injections, Intraocular
• Male
• Methylprednisolone (administration & dosage, adverse effects, analogs & derivatives)
• Methylprednisolone Acetate
• Orbit
• Retrospective Studies
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage, adverse effects)
• Uveitis (drug therapy, physiopathology)
• Visual Acuity (physiology)