J Korean Ophthalmol Soc.  2011 Jul;52(7):788-793. 10.3341/jkos.2011.52.7.788.

Therapeutic Effects of Periocular Injection of Triamcinolon Acetonide in Patients with Thyroid-Associated Ophthalmopathy

• Kim JE
• Park JW
• Cho JK
• Yoon KC

• KMID: 2214702
• DOI: http://doi.org/10.3341/jkos.2011.52.7.788

Abstract

PURPOSE
The present study investigated the therapeutic effects of periocular triamcinolone acetonide injections to treat inflammatory signs in patients with severe acute thyroid-associated ophthalmopathy.
METHODS
Twenty-two patients with symptoms of severe acute thyroid ophthalmopathy were enrolled in the present study. The patients received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The changes in visual acuity, intraocular pressure, eye ball motility, exophthalmos, thickness of extraocular muscles, clinical activity score and NOSPECS score were measured.
RESULTS
Eighteen of 22 patients (81.8%) showed improvement in soft tissue swelling, ten patients (45.5%) showed improvement in conjunctival hyperemia and one patient showed improvement of ocular motility. Clinical activity score and NOSPECS score had significant improvements. No patient had changes in visual acuity, intraocular pressure, diplopia, proptosis or thickness of extraocular muscles. An ocular adverse effect was found in one patient, who had subcutaneous fat atrophy at the injection site.
CONCLUSIONS
In patients with severe acute thyroid ophthalmopathy, periocular triamcinolone acetonide injection can be effective to improve acute inflammatory symptoms, without significant adverse effects.

Keyword

Periocular injection; Thyroid-associated ophthalmopathy; Triamcinolone

MeSH Terms

Atrophy
Diplopia
Exophthalmos
Eye
Graves Ophthalmopathy
Humans
Hyperemia
Injections, Intraocular
Intraocular Pressure
Muscles
Orbit
Subcutaneous Fat
Thyroid Gland
Triamcinolone
Triamcinolone Acetonide
Visual Acuity
Triamcinolone
Triamcinolone Acetonide