Subconjunctival dexamethasone implant for non-necrotizing scleritis

Background: The purpose of this study is to report the management of non-necrotizing anterior scleritis with a single-dose subconjunctival 0.7 mg dexamethasone implant (Ozurdex (R), Allergan, Inc., CA, USA). Six patients with clinical diagnosis of non-necrotizing anterior scleritis (diffuse, sectorial, and nodular) were submitted to subconjunctival injection of dexamethasone implant. The injection was performed under topical anesthesia at the slit lamp. All patients reported only mild discomfort related to the procedure. Five patients had subconjunctival hemorrhage. Follow-up was performed 1, 7, 15, 30, and 45 days, and 2, 3, 4, 5, and 6 months after the procedure. Visual acuity, intraocular pressure, anterior and posterior biomicroscopy, and fundus exams were performed in each visit. Results: In all patients, symptoms disappeared before day 7, and most of them were symptoms-free on day 2. The implant was visible at least up to day 45. One recurrence was noted in the 6-month follow-up in a patient with rheumatoid arthritis and non-necrotizing diffuse scleritis and was treated with oral steroids. No patient developed ocular hypertension or any kind of complications during the follow-up period, except for subconjunctival hemorrhage. Conclusion: Dexamethasone implant was safely and effectively used as a local therapy for non-necrotizing scleritis.