Bilateral Triamcinolone Induced Subconjunctival Granuloma in the Treatment of Scleritis Accompanied by Scleral Ectasia in a Dog

다국어 초록 (Multilingual Abstract)

A 6-year-old spayed female American Cocker Spaniel presented with episcleritis in the right and then theleft eye (OS) at eight month interval. Repeated intralesional triamcinolone acetonide was administered subconjunctivallyto both eyes (OU). During this period, scleral ectasia was revealed on ocular funduscopy OS and then confirmedon ultrasonography and computed tomography. A year later, conjunctival hyperemia occurred around remnanttriamcinolone particles and was treated by resection of these particles in the OU. A recurrence of episcleritis, whichdid not regress, required repeated triamcinolone subconjunctival injections four months later in the OU. Four monthsafter these injections OU, the dog was presented with bilateral conjunctival mass, which had developed over the previousmonth. The round-shaped masses with diameters of 1 cm were surgically resected from exposed scleral ectasia lesionof thin and bulging scleral surface in the OU. The cross-section of both masses showed a white-colored accumulationat the center and triamcinolone induced granulomas enclosing necrotic tissue were confirmed by impression cytologyand histopathological examination.

참고문헌 (Reference)

1 Rankin A, "Veterinary Ophthalmology" John Willey & Sons 407-422, 2013

2 Ledbetter EC, "Veterinary Ophthalmology" John Willey & Sons 976-1049, 2013

3 Grahn BH, "Veterinary Ophthalmology" John Willey & Sons 435-523, 2013

4 Hendrix DVH, "Veterinary Ophthalmology" John Willey & Sons 945-975, 2013

5 Ozzello DJ, "Uveitis Specialists and Rheumatologists Select Different Therapies for Idiopathic Non-necrotizing Anterior Scleritis" 5 : 245-252, 2016

6 Helm CJ, "The effects of posterior subtenon injection of triamcinolone acetonide in patients with intermediate uveitis" 120 : 55-64, 1995

7 Maggs DJ, "Slatter's Fundamentals of Veterinary Ophthalmology" Elsevier Saunders 184-219, 2013

8 Maggs DJ, "Slatter's Fundamentals of Veterinary Ophthalmology" Elsevier Saunders 27-59, 2013

9 Abel AD, "Sclerosing lipogranuloma of the orbit after periocular steroid injection" 110 : 1841-1845, 2003

10 Paris F dos S, "Postoperative subconjunctival corticosteroid injection to prevent pterygium recurrence" 27 : 406-410, 2008

11 Giangiacomo J, "Histopathology of triamcinolone in the subconjunctiva" 94 : 149-153, 1987

12 Ferry AP, "Histopathologic features of subconjunctivally injected corticosteroids" 15 : 716-718, 1987

13 Hakanson N, "Granuloma formation following subconjunctival injection of triamcinolone in two dogs" 27 : 89-92, 1991

14 Fischer CA, "Granuloma formation associated with subconjunctival injection of a corticosteroid in dogs" 174 : 1086-1088, 1979

15 Carlson AN, "Fungal scleritis after cataract surgery. Successful outcome using itraconazole" 11 : 151-154, 1992

16 Chan CK, "Encapsulated triamcinolone cyst after subtenon injection" 34 : 360-362, 2006

17 Grahn BH, "Diagnostic ophthalmology. Necrotic scleritis and uveitis" 40 : 679-680, 1999

18 Byun YS, "Complications and safety profile of posterior subtenon injection of triamcinolone acetonide" 25 : 159-162, 2009

19 Nessim M, "Anterior scleritis, scleral thinning, and intraocular pressure measurement" 13 : 455-457, 2005

20 Zamir E, "A prospective evaluation of subconjunctival injection of triamcinolone acetonide for resistant anterior scleritis" 109 : 798-805, 2002