Kerala Journal of Ophthalmology (Jan 2020)

A clinical study on the efficacy of posterior subtenon injection of triamcinolone acetonide in patients with post fever retinitis

  • Parvathy Prabhakaran Sreelatha,
  • Pavana Krishnaraj Acharya,
  • Kavitha Chikkanayakanahalli Venugopal,
  • Renuka Sivakiran

DOI
https://doi.org/10.4103/kjo.kjo_2_20
Journal volume & issue
Vol. 32, no. 2
pp. 148 – 153

Abstract

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Aims: The aim of this study was to assess the visual outcome and fundoscopic changes following posterior subtenon (PST) injection of triamcinolone acetonide (TA) in patients with post fever retinitis. Settings and Design: This was a prospective interventional study. Subjects and Methods: A prospective interventional study was conducted on 12 patients with post fever retinitis responding poorly to systemic steroids or with contraindications to systemic steroids. Patients were treated with PST injection of 0.5 ml TA (20 mg). They were followed up for 6 months during which best-corrected visual acuity (BCVA), fundus changes, and intraocular pressure (IOP) were evaluated. Statistical Analysis Used: Descriptive statistics and paired t-test were used in this study. Results: All patients had BCVA <6/60 at presentation. Three patients (25%) had retinitis patch alone, five patients (41%) had retinitis with macular edema, and four patients (34%) had retinitis and macular edema in the presence of other features such as vasculitis or disc edema at the time of presentation. On a 6-month follow-up after PST with TA, nine patients (75%) improved to a BCVA of 6/12 or more. One patient improved to 6/18 and two patients improved to 6/24. The mean logMAR visual acuity before PST was 1.349 which improved to a mean logMAR of 0.248 following PST injection with TA (P < 0.001). Six patients (50%) had a total resolution at 6 months, four patients (34%) had a total resolution with atrophic scars, and two patients (16%) had an incomplete resolution. None of the patients had a significant increase in IOP. Conclusions: PST with TA can be considered as an alternative treatment for post febrile retinitis, especially when the response to systemic steroids is poor or in the presence of contraindications to systemic steroids.

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