TY - JOUR
T1 - Periocular corticosteroid injection in the management of uveitis in children
AU - Habot-Wilner, Zohar
AU - Sallam, Ahmed
AU - Roufas, Athena
AU - Kabasele, Paul Mb
AU - Grigg, John R.
AU - McCluskey, Peter
AU - Lightman, Sue
PY - 2010/12
Y1 - 2010/12
N2 - 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.
AB - 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.
KW - children
KW - corticosteroids
KW - orbital floor injection
KW - periocular injection
KW - uveitis
UR - http://www.scopus.com/inward/record.url?scp=78649837857&partnerID=8YFLogxK
U2 - 10.1111/j.1755-3768.2010.02025.x
DO - 10.1111/j.1755-3768.2010.02025.x
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C2 - 21114631
AN - SCOPUS:78649837857
SN - 1755-375X
VL - 88
SP - e299-e304
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
IS - 8
ER -