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Supratarsal injection of triamcinolone acetonide and childhood allergic keratoconjunctivitis
Sonia Zaouali1, Rim Kahloun, Sonia Attia
1Department of Ophthalmology, Fattouma Bourguiba University Hospital, 5019, Monastir, Tunisia.
Insights
Supratarsal triamcinolone acetonide injections effectively treated severe childhood allergic keratoconjunctivitis, including atopic and vernal forms. While generally safe, one patient with vernal keratoconjunctivitis developed ocular hypertension.
Area of Science:
- Ophthalmology
- Pediatric Allergy
- Pharmacology
Background:
- Severe allergic keratoconjunctivitis, encompassing atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC), presents significant challenges in pediatric patients.
- Refractory cases often require advanced treatment strategies to manage intense ocular inflammation and prevent vision-threatening complications.
Purpose of the Study:
- To assess the efficacy and safety of supratarsal injection of triamcinolone acetonide for severe, treatment-resistant allergic keratoconjunctivitis in children.
- To evaluate the resolution of clinical signs and symptoms, as well as the occurrence of adverse events.
Main Methods:
- A cohort of 35 pediatric patients (70 eyes) with severe AKC or VKC received bilateral supratarsal injections of 20 mg triamcinolone acetonide.
- Patients were monitored for symptom improvement, clinical feature resolution, and side effects over a mean follow-up period of 28 months.
Main Results:
- All patients experienced significant symptomatic improvement and partial resolution of keratoconjunctivitis signs within two weeks.
- Corneal complications resolved in all participants; one VKC patient developed ocular hypertension, while no AKC patients reported side effects.
- Relapse rates were 10% for VKC and 6.7% for AKC eyes after approximately 9-11 months.
Conclusions:
- Supratarsal triamcinolone acetonide injection is a safe and effective treatment for severe chronic allergic keratoconjunctivitis in children.
- This method provides substantial relief from severe ocular inflammation associated with both AKC and VKC.
Abstract:
To evaluate the efficacy and safety of supratarsal injection of triamcinolone acetonide in the treatment of refractory allergic keratoconjunctivitis in childhood. Thirty-five patients (70 eyes) with severe allergic keratoconjunctivitis were included in this study. Fifteen patients (42.8%) had atopic keratoconjunctivitis (AKC) and 20 (57.2%) had vernal keratoconjuncivitis (VKC). All patients underwent a bilateral supratarsal injection of 20 mg triamcinolone acetonide. Mean follow-up was 28 months (range 14-38). All patients showed a significant symptomatic improvement and partial resolution of clinical features of keratoconjunctivitis within the first 2 weeks. Corneal complications related to keratoconjunctivitis disappeared in all patients. One patient with VKC experienced ocular hypertension. No patient with AKC showed side-effects. Severe relapse of the disease was noted in 10% of eyes with VKC and in 6.7% of eyes with AKC after a mean follow-up of 9 and 11 months, respectively. Supratarsal injection of triamcinolone acetonide is effective and safe in patients with severe chronic allergic keratoconjunctivits to relieve severe inflammation associated with this disease.
