Suprachoroidal Triamcinolone Injection for the Management of Chronic Uveitis-Associated Ocular Hypotony.

Abstract

Purpose: This study is aimed at describing the use of suprachoroidal triamcinolone injection for the treatment of refractory uveitis-associated ocular hypotony presumed secondary to ciliary body shutdown.

Methods: We report a case of a 58-year-old woman with a 26-year history of idiopathic, noninfectious bilateral panuveitis complicated by recurrent cystoid macular edema and a steroid-induced ocular hypertension. After treatment with an intravitreal dexamethasone implant and an Ahmed glaucoma valve, she developed persistent hypotony in the right eye with intraocular pressure (IOP) of 2-4 mmHg despite controlled inflammation. Evaluation with gonioscopy and ultrasound biomicroscopy revealed no cyclodialysis cleft or cyclitic membranes. Prior treatments, including topical steroids, repeat dexamethasone implant, Ahmed valve revision, and serial anterior chamber viscoelastic injections, produced only transient improvement. Suprachoroidal triamcinolone (40 mg) was administered.

Results: Before injection, IOP ranged from 2 to 6 mmHg. Following treatment, IOP remained ≥ 6 mmHg for approximately 2 months. Best corrected visual acuity improved from 20/80 to 20/50, and additional viscoelastic injections were not required during this period. Numerical hypotony recurred 8 months later.

Conclusion: Suprachoroidal triamcinolone may represent a targeted treatment for refractory uveitis-associated hypotony when ciliary body dysfunction is suspected and other steroid delivery routes are limited. Further study is needed to evaluate durability and broader applicability.