Acta Scientific Clinical Case Reports

Case ReportVolume 4 Issue 1

Steroid-induced Ocular Hypertension in Case of Gyrate Atrophy Treated with Posterior Sub Tenon Triamcinolone Acetonide for Cystoid Macular Edema

Prasanth K Athota1*, Srinivasulu R Yekollu2, Satya S Yalla3, Raju K Vadrevu3 and Leela V Raju4

1Department of Anterior Segment and Neuroophthalmogy Services, Goutami Eye Institute, Rajahmundry, India
2Department of VitreoRetinal Services, Goutami Eye Institute, Rajahmundry, India
3Department of Comprehensive Ophthalmology, Goutami Eye Institute, Rajahmundry, India
4NYU Langone Health, New York, USA

*Corresponding Author: Prashanth K Athota, Department of Anterior Segment and Neuroophthalmogy Services, Goutami Eye Institute, Rajahmundry, India.

Received: November 16, 2022; Published: December 05, 2022

Abstract

Gyrate atrophy is a rare congenital retinal dystrophy that causes cystoid macular edema (CME). The treatment options include intravitreal bevacizumab, intravitreal triamcinolone, topical carbonic anhydrase inhibitors, and subtenon steroid injections. The raised IOP may be controlled with IOP-lowering medication or can be refractory to any medication. Early tenotomy and removing PST deposits may give the patient early rehabilitation. We discuss a 17-year-old male presented with a painless diminution of vision in both eyes. The ocular examination revealed gyrate atrophy with cystoid macular edema. A sub-tenon injection of 40mg triamcinolone was given, for which the patient developed elevated intraocular pressure. The raised IOP was refractory to antiglaucoma medications. The patient was treated with a micropulse transscleral cyclodiode laser (MP3 laser) followed by surgical removal of subtenon triamcinolone deposits to reduce intraocular pressure.

Keywords: Cystoid Macular Edema; Gyrate Atrophy; Intraocular Pressure; Micropulse Transscleral Photocoagulation; Posterior Sub Tenon Triamcinolone

Bibliography

  1. O’Donnell JJ., et al. “Gyrate atrophy of the retina: inborn error of L ornithin:2-oxoacid aminotransferase”. Science 4338 (1978): 200-201.
  2. Ramesh V., et al. “The ornithine aminotransferase (OAT) locus: analysis of RFLPs in gyrate atrophy”. American Journal of Human Genetics 2 (1988): 365-372.
  3. Ramesh V., et al. “Molecular basis of ornithine aminotransferase deficiency in B-6-responsive and -nonresponsive forms of gyrate atrophy”. Proceedings of the National Academy of Sciences of the United States of America 11 (1988): 3777-3780.
  4. Takki K. “Gyrate atrophy of the choroid and retina associated with hyperornithinaemia”. British Journal of Ophthalmology1 (1974): 3-23.
  5. Heller D., et al. “Reversal of cystoid macular edema in gyrate atrophy patients”. Ophthalmic Genetics6 (2017): 549-554.
  6. Iwao K., et al. “Frequency and risk factors for intraocular pressure elevation after posterior sub-Tenon capsule triamcinolone acetonide injection”. Journal of Glaucoma2 (2007): 251-256.
  7. Maeda Y., et al. “Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan”. PLOS ONE12 (2019): e0226118.
  8. Kim S., et al. “Gyrate Atrophy of the Choroid and Retina Diagnosed by Ornithine-δ-aminotransferase Gene Analysis: A Case Report”. Korean Journal of Ophthalmology5 (2013): 388.
  9. Rotsos TG and Moschos MM. “Cystoid macular edema”. Clinical Ophthalmology 4 (2008): 919-930.
  10. Sanchez FG., et al. “Update on Micropulse Transscleral Cyclophotocoagulation”. Journal of Glaucoma7 (2020): 598-603.

Citation: Prasanth K Athota., et al. “Steroid-induced Ocular Hypertension in Case of Gyrate Atrophy Treated with Posterior Sub Tenon Triamcinolone Acetonide for Cystoid Macular Edema". Acta Scientific Clinical Case Reports 4.1 (2023): 06-08.

Copyright: © 2022 Prasanth K Athota., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 20, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US