Steroid-induced ptosis: case studies and histopathologic analysis.

Area of Science:

• Ophthalmology
• Steroid Therapy
• Eyelid Surgery

Background:

• Subtenon steroid injections are used to treat various ocular inflammatory conditions.
• Ptosis, or drooping of the eyelid, is a potential complication following these injections.
• The exact mechanism of steroid-induced ptosis remains unclear.

Purpose of the Study:

• To investigate the occurrence and characteristics of ptosis after subtenon triamcinolone acetonide injections in patients.
• To explore the potential mechanism of steroid-induced ptosis using an animal model.

Main Methods:

• Retrospective review of 22 uveitis patients who received posterior subtenon triamcinolone acetonide injections, evaluating ptosis onset and severity.
• Histopathological analysis of levator muscle and aponeurosis in rabbits following subtenon triamcinolone injection.

Main Results:

• Ptosis developed in patients a mean of 13.9 months after injection, with earlier onset after single injections.
• Seventeen patients required ptosis repair.
• No ptosis or significant histopathological changes (atrophy, inflammation) were observed in the rabbit levator muscle or aponeurosis.

Conclusions:

• Ptosis following subtenon steroid injection can occur months later and range from mild to moderate.
• Despite previous findings of muscle degeneration with corticosteroids, this study found no histopathological changes in the levator muscle or aponeurosis in the animal model.
• The mechanism behind steroid-induced ptosis may not involve direct degenerative changes in the levator muscle or aponeurosis.