Periocular and Intravitreal Steroid Use in Treatment of Behcet’s Disease Related Uveitis

Behcet’s disease has an intractable chronic recurrent course and ocular involvement is one of the most important morbidity reasons. Systemic steroids and immunosuppressive constitute the basis of treatment in ocular involvement. However, both the side effects and the necessity of high dosages for ocular penetration of the medications favors the local treatment options. Periocular injections (orbita floor and subtenon) in this manner are found to be effective as an adjuvant in treatment of intractable disease, reducing the systemic dosage and preventing the recurrences. In intravitreal route the most commonly used is triamsinolon asetonid (IVTA) injection. With this route, local depot efect, rapid impact on posterior segment and retinal vasculitis, better outcomes in vitreus haze and macular edema can be achieved. However, complications like cataract and intraocular pressure (IOP) rise are commonly seen. Other options in intravitreal route are Flucinolone acetonide (Retisert®) and dexamethazon (Ozurdex®) implants. Ozurdex® becomes a suitable treatment option with its long lasting effect and low side effect profile compared to IVTA. Although, Retisert® seems effective with its action that might extend to 3 years, the necessity of surgery for implantaton and high rate of cataract and glaucoma complications, it is not preferred frequently.