triamcinolone (Trivaris / Trivaris)

Transient intraocular lens opacification after intravitreal triamcinolone injection.

Cardoso-Teixeira Pedro P, Duarte Lilianne L, Costa Ferreira Cláudia C

Haemorrhagic Occlusive Retinal Vasculitis Following Cataract Surgery Without Intraocular Vancomycin.

Grech Sarah S, Bezzina Alastair A, Calleja Andrea A

This paper reports a rare case of haemorrhagic occlusive retinal vasculitis (HORV) following cataract surgery in the absence of intraocular vancomycin, raising important considerations about alternative aetiologies and perioperative management. A 79-year-old male patient with a background of type 2 diabetes, benign prostatic hyperplasia and asthma experienced recurrent hypersensitivity reactions to topical mydriatics during preoperative assessments for right eye cataract surgery in the private sector. Surgery was ultimately performed without topical mydriatics; full mydriasis was achieved with the use of intracameral mydriatic agents and iris hooks. No intraocular vancomycin was administered. Postoperative care included standard antibiotic-steroid eye drops. Three days postoperatively, the patient presented with sudden, painless vision loss. Examination revealed extensive retinal haemorrhages, vasculitis, and macular ischaemia. Imaging confirmed widespread retinal vascular damage. Infectious and autoimmune screens were negative. A diagnosis of HORV was made, and the patient was treated with intravenous methylprednisolone, topical corticosteroids, and later sub-tenon triamcinolone. Partial visual improvement was observed. This case highlights the possibility of HORV in the absence of vancomycin, suggesting that other immune-mediated or hypersensitivity pathways, in response to different triggers, may contribute to its pathogenesis.

Blaschko-Linear Lupus Erythematosus in a Pediatric Patient.

Hall Marshall M, Mayer Olivia O, Lim Henry H, Wilkes Dustin V DV et al.

The lines of Blaschko represent epithelial cell migration during embryonic development. Rare forms of cutaneous lupus erythematosus may manifest along these lines, and lesions are termed Blaschko-linear lupus erythematosus (BLE). The purpose of this case study is to present a rare manifestation of linear cutaneous lupus erythematosus following the lines of Blaschko in a pediatric patient. To date, there are very few reports of BLE. We present a 17-year-old female with a 2-month history of a mildly tender growing lesion along the right nasofacial sulcus. The patient denied lesions elsewhere and any systemic, joint, or mucosal symptoms. A biopsy of the lesion was consistent with cutaneous lupus erythematosus. Given the distribution and pathology, the patient was diagnosed with BLE. The patient was treated with intralesional triamcinolone, topical pimecrolimus, and systemic hydroxychloroquine with an emphasis on strict photo-protection. Despite these therapies the patient's disease persisted.

A Minimally Invasive Needle-Free Modified Cut-Down Technique for Posterior Sub-Tenon's Corticosteroid Injection.

Rostomian Nairi N, Kaganovski Adriana A, Kamen Dan D, Holt Henry H et al.

To describe a minimally invasive needle-free modified cut-down technique for posterior sub-Tenon's corticosteroid injection that avoids blind orbital needle passage and is suitable for office-based retinal practice. A stepwise surgical technique is described for posterior sub-Tenon's triamcinolone delivery using a 1-2 mm conjunctival incision, blunt dissection along the scleral surface, and flexible 27-gauge cannula-based injection. The technique was successfully implemented in an outpatient retinal clinic setting. In initial clinical use, no intraoperative complications were encountered, and the procedure was well tolerated. This modified needle-free cut-down technique provides a reproducible method for posterior sub-Tenon's corticosteroid delivery in outpatient retinal practice while eliminating blind orbital needle passage. It may provide a more controlled alternative to traditional techniques while potentially reducing the risks associated with blind sharp orbital needle passage.