What's new AAPOS 2008 - The Private Eye Clinic

This article describes a 7-month-old infant with posterior scleritis diagnosed on the basis
of B-scan ultrasonography and computed tomography. The patient was initially
diagnosed with preseptal cellulites and endophthalmitis. Posterior scleritis should be
considered in the differential diagnosis of acute orbital inflammation in children younger
than one year.
SHORT-TERM SAFETY AND EFFICACY OF INTRAVITREAL TRIAMCINOLONE
ACETONIDE FOR UVEITIC MACULAR EDEMA IN CHILDREN
Ahmed Sallam MD FRCS; Richard M Comer MD FRCOphth; John H Chang MD; John
R Grigg FRACO FRACS; Richard Andrews FRCOphth; Peter J McCluskey MD FRACO;
Susan Lightman PhD FRCOphth
Arch Ophthalmol 2008;126(2):200-205
This was a retrospective noncomparative interventional case series to evaluate the
short-term safety and efficacy of intravitreal (IV) triamcinolone acetonide (TA) for
treating pediatric cystoid macular edema (CME) secondary to noninfectious uveitis.
Medical records of 15 consecutive children (16 eyes) with uveitic CME treated with IVTA
(2 or 4 mg) were reviewed. Data collected included details of uveitis, CME, visual
acuity, intraocular pressure, and cataract development. The median follow-up time was
16 months (range, 9-36 months).
Resolution of CME was achieved in all treated eyes, with a median time for CME
resolution at 3 weeks (range, 1-24 weeks). Mean improvement of visual acuity after
IVTA was 0.6 logarithm of the minimum angle of resolution. CME relapsed in 5 eyes
(31%) after a median time of 7 months (range, 3-13 months). The most common
adverse effect was increased intraocular pressure, with an increase of more than 15
mm Hg in 5 eyes (31%). Steroid-induced cataract was observed in 6 of 11 phakic eyes
(55%).
The authors found that IVTA is efficacious in the treatment of uveitic CME in children
and results in CME resolution and visual acuity improvement. As in adults, treatment in
children may be associated with elevated intraocular pressure and cataract.
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