USE OF SUPRACHOROIDAL TRIAMCINOLONE ACETONIDE IN PEDIATRIC UVEITIS

To evaluate the off-label use and safety of suprachoroidal triamcinolone acetonide (SCS-TA) for pediatric uveitic macular edema, retinal vasculitis, and perioperative control of inflammation.

Medical records of pediatric patients who received SCS-TA were reviewed. Primary outcomes were visual acuity, intraocular pressure (IOP), and central subfield thickness (CST).

In this retrospective cohort study of eight pediatric patients (10 eyes), median age was 14 years (7‒17 years), and median follow-up duration was 10.5 months (range 6‒22 months). Seven of 10 eyes (70.0%) showed stable or improving visual acuity after SCS-TA injection. Median improvement in visual acuity was 1 line (range 0‒6 lines). Four of 10 eyes had a history of steroid-related IOP elevation due to other agents. One of 10 eyes (10.0%) had a clinically significant increase in IOP (IOP ≥ 21 mmHg and ≥10 mmHg IOP increase from baseline) after SCS-TA injection. Intraocular pressure was controlled only requiring topical drops and did not require surgical intervention. One of 10 phakic eyes (10%) developed a cataract during follow-up. In eyes that received SCS-TA for uveitic macular edema, median improvement in CST was 72 µ m (55‒352 µ m) at last follow-up. There was improvement in retinal vasculitis after injection and no recurrence of uveitis or uveitic macular edema in those receiving SCS-TA before surgery.

Suprachoroidal triamcinolone acetonide injection demonstrated an adequate safety profile for pediatric patients with favorable IOP outcomes and limited adverse effects. SCS-TA may be considered for treatment of pediatric uveitic macular edema, retinal vasculitis, and perioperative control of inflammation in children with uveitis undergoing cataract/glaucoma surgery.