Subconjunctival Triamcinolone Acetonide in the Treatment of Non-necrotizing, Non-infectious Anterior Scleritis

Non-necrotizing, non-infectious anterior scleritis often requires systemic corticosteroids or immunosuppressants, which carry significant adverse effects. Local therapy in the form of subconjunctival triamcinolone acetonide injections (STI) can be beneficial in such patients.

This retrospective case series included six eyes of six patients treated with STI. Patients underwent detailed ocular and systemic evaluation prior to injection. Under peribulbar anesthesia, 2-4 mg of preservative-free triamcinolone acetonide was injected subconjunctivally at the site of inflammation. Patients were monitored for pain relief, congestion, intraocular pressure (IOP), cataract progression, and scleral necrosis.

Four patients had diffuse and two had nodular scleritis. All patients achieved symptomatic relief and reduction in inflammation within one to two weeks. All patients were able to reduce or discontinue systemic immunosuppressive therapy. The mean symptom-free interval was 4.5 months, and the mean follow-up duration was 12.3 months. Complications included transient ocular hypertension in one patient and cataract progression in another. No cases of scleral necrosis were observed.

STI provides effective local disease control and symptom relief in non-necrotizing, non-infectious anterior scleritis, while reducing systemic treatment burden. They appear to be a safe, cost-effective adjunct, though careful patient selection and monitoring for IOP elevation are essential.