Purpose: To evaluate the off-label use and safety of suprachoroidal triamcinolone acetonide (SCS-TA) for pediatric uveitic macular edema (UME), retinal vasculitis, and perioperative control of inflammation. Methods: Medical records of pediatric patients that received SCS-TA were reviewed. Primary outcomes were visual acuity (VA), intraocular pressure (IOP), and central subfield thickness (CST). Results: In this retrospective cohort study of eight pediatric patients (ten eyes), median age was 14 years (7-17 years), and median follow-up duration was 10.5 months (range 6 to 22 months). Seven of ten eyes (70.0%) showed stable or improving VA following SCS-TA injection. Median improvement in VA was 1 line (range 0-6 lines). Four of ten eyes had a history of steroid-related IOP elevation due to other agents. One of ten eyes (10.0%) had a clinically significant increase in IOP (IOP ≥ 21 mmHg and ≥ 10 mmHg IOP increase from baseline) following SCS-TA injection. IOP was controlled only requiring topical drops and did not require surgical intervention. One of ten phakic eyes (10%) developed a cataract during follow-up. In eyes that received SCS-TA for UME, median improvement in CST was 72 μm (55-352 μm) at last follow-up. There was improvement in retinal vasculitis following injection and no recurrence of uveitis or UME in those receiving SCS-TA prior to surgery. Conclusions: SCS-TA 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 UME, retinal vasculitis, and perioperative control of inflammation in children with uveitis undergoing cataract/glaucoma surgery.
Hanson et al. (Tue,) studied this question.