SEVERE CIRCULATORY DISTURBANCE IN OPTIC DISK, RETINA, AND CHOROID AFTER SUB-TENON TRIAMCINOLONE ACETONIDE INJECTION FOR POSTERIOR SCLERITIS.

PURPOSE: To report a rare case of optic disk and chorioretinal vascular occlusions in the right eye after sub-Tenon injection of triamcinolone acetonide (STTA) in an older male patient with scleritis and to discuss the associated risk factors and potential alternative therapies.

METHODS

The medical history and clinical examination, including fundoscopy, fluorescein angiography (FA), and indocyanine green angiography (ICGA), were conducted to diagnose and evaluate the extent of vascular occlusion after STTA. An extensive literature review was undertaken to ascertain the associated risks and consider other treatment options for scleritis.

RESULTS

Severe circulatory disturbances in the optic disk and chorioretinal regions of the right eye developed after STTA for exacerbated scleritis, as confirmed by FA and ICGA, resulting in a significant decrease in visual acuity. A complex medical history encompassing ophthalmic and systemic health issues may have contributed to this negative outcome. A literature review pointed out the potential complications of STTA and highlighted alternative approaches to scleritis management.

CONCLUSION

Cautious application of STTA in treating scleritis is crucial, especially in patients with preexisting vascular or ocular conditions. Thus, a multidisciplinary approach and a careful assessment of various treatment options are vital to minimize the risk of severe complications and improve patient outcomes.