Conjunctival necrosis and scleritis following subtenon triamcinolone acetonide injection

Abstract

The present study aims to report a case of conjunctival necrosis and scleritis due to a subtenon injection of triamcinolone acetonate. A 15-year-old boy received a subtenon injection of triamcinolone acetonate after a pars plana vitrectomy due to an intraocular foreign body. Seven days later, conjunctival necrosis and scleritis appeared at the site of injection. No improvement was seen after seven days of conservative treatment, and necrotic tissue debridement was performed. Within one week the conjunctiva cleared. Conjunctival necrosis and scleritis are rare complications of periocular corticosteroid injections, but an early diagnosis can be very valuable. Improper dosage and injection site of corticosteroids with insufficient prophylactic antibiotics are predisposing factors. If conservative treatment is not sufficient, debridement should be considered as a potential critical treatment option.

Keywords: Complications; Conjunctival Necrosis; Corticosteroids; Subtenon Injection; Triamcinolone acetonate.

Figure 1.. Necrotizing Sclerititis With Conjunctival Necrosis

Figure 2.. Sclera Beneath the Epithelial Defect was Inflamed by Engorged Vessels and Mild Thinning

Figure 3.. Pathology Report was Connective Tissue With Necrosis and PMN Infiltration