We would like to respond to the comments from Dr Park in reference to the recently published case series describing sub-Tenon triamcinolone acetonide injections in the treatment of scleritis. All patients were receiving systemic therapy at the time of injection; we agree that these medications could have a confounding effect when evaluating the impact of regional corticosteroid treatment. We suggest the injections are helpful as an adjunct therapy, and are not intended to replace systemic approaches. An inherent disadvantage of this case series is the inability to compare regional corticosteroids with no treatment. We selected a short initial follow-up time of 2 to 5 weeks to attempt to capture the rapid effect of the injections. We agree that this time range is variable, but were limited by the retrospective nature and number of patients in the study.

In the “Results,” we comment that 2 patients who received injections were excluded because they did not meet inclusion criteria of initial follow-up within 5 weeks. One patient had follow-up at 8 weeks, and 1 patient did not return at all for follow-up. These patients were not included in our data or in the Table. We appreciate the identification of errors in the “Results” (line 2) and “Discussion” (line 28) on the use of subconjunctival corticosteroid injections (SCIs). This may cause misunderstanding among readers, as we intended to mention sub-Tenon injections in these sentences.

We found that adverse side effects in our small case series were manageable. Dr Park’s recently published large case series also reported a low incidence of side effects, including elevated intraocular pressure and cataract progression, and no severe complications like endophthalmitis or retinal detachment, in their use of posterior sub-Tenon triamcinolone acetonide injections.

We appreciate the response by Dr Park and agree that sub-Tenon corticosteroid injections could be considered an adjunct in treating nonnecrotizing scleritis.

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Jan 17, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Reply

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