Posters

Evaluation of intratarsal injection of triamcinolone in severe atopy

Poster Details

First Author: M.Sefrioui MOROCCO

Co Author(s): K. Belkhadir   I. Ed-Darraz   N. Taouri   N. Boutimzine   O. Cherkaoui        

Abstract Details

Purpose:

Vernal keratoconjunctivitis (VKC) patients are often resistant to conventional treatments. The long-term use of topical steroids may lead to blinding complications such as glaucoma, and cataract. Nevertheless, the severe clinical presentations of some patients and the frequent recurrences impose their prolonged use. Successful management of refractory VKC or VKC complicated with atopic keratoconjunctivitis with intra tarsal injection of triamcinolone has been reported. We report two clinical cases with very good outcomes after this treatment.

Setting:

Ophthalmology Unit A, Hopital des Spécialités, Mohammed V University in Rabat.

Methods:

The first patient is a 12-year old child with general atopy, and recurrent VKC treated several times with topical dexamethasone, antihistamines and mast cell stabilizers, with partial improvement of symptoms. At the clinical examination, we found a severe photophobia, conjonctival hyperhemia, giant conjunctival papillae. The second one is a 15-year old boy, with history of VKC, complicated with atopic keratoconjunctivitis. At his clinical examination we found a limbic insufficiency, with superficial corneal neovessels,  and corneal opacity on the periphery. We performed for both of them an intra tarsal injection of 20 mg of triamcinolone in each eye.

Results:

The clinical examination after 1 month found a clear improvement of the functional symptoms: decrease in pruritus, photophobia, and tearing. Papillary conjunctivitis decreased in both patients. The appearance of the cornea has also improved with the regression of neovessels. No complications was noticed during the follow up with a good treatment tolerance. Control of the intraocular pression was normal at Day 7, 1 month and 3 months after the injection.

Conclusions:

Treatment of severe VKC is a difficult problem for the patient and the physician. Current topical medical treatments are not fully effective. More recently, new agents such as topical cyclosporine were used but after cessation of treatment, symptoms and signs recurred. the treatment of refractory VKC or VKC complicated with atopic keratoconjunctivitis in children with intra tarsal injection of triamcinolone is an effective and safe technique which provide good outcomes and longer relief with less recurrences.

Financial Disclosure:

None