Orbital corticosteroid injections for the treatment of active thyroid eye disease
PurposeTo study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.MethodsPatients that received orbital injection(s) of triamcinolone acetonide mixed 1:1 with dexamethasone for thyroid eye disease were included i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Ophthalmology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fopht.2023.1296092/full |
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| author | Kevin T. Eid Kevin T. Eid Peter M. Kally Peter M. Kally Alon Kahana Alon Kahana Alon Kahana |
| author_facet | Kevin T. Eid Kevin T. Eid Peter M. Kally Peter M. Kally Alon Kahana Alon Kahana Alon Kahana |
| author_sort | Kevin T. Eid |
| collection | DOAJ |
| description | PurposeTo study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.MethodsPatients that received orbital injection(s) of triamcinolone acetonide mixed 1:1 with dexamethasone for thyroid eye disease were included in this retrospective study. Demographic and clinical data were collected from the pre-treatment and 1 month follow up evaluations. Clinical data included subjective pain and diplopia scores, best-corrected visual acuity, Intraocular pressure, extraocular motility, clinical activity score, Hertel exophthalmometry, and upper eyelid margin to reflex distance.ResultsFifteen patients, 33 orbital injections, were included in the study. The average patient age was 59.2 years (SD ± 13.0) and 89% female. Subjectively, 67% of patients reported improvement of orbital pain and pressure versus 28% stable and 5% worse (p <0.001). Post-procedure clinical activity score decreased from 3.84 to 3.00 (p = 0.0004). There were no significant differences in upper eyelid margin to reflex distance (4.1 ± 1.4 mm vs. 4.3 ± 2.6 mm, p = 0.45), Hertel exophthalmometry (21.7 ± 9.4 mm vs. 21.8 ± 7.6 mm, p = 0.56), or extraocular motility (21% improved vs. 72% stable and 7% worsening, p = 0.50). No steroid-responsive increases in intraocular pressure or injection-related complications were reported.ConclusionOrbital steroid injections can successfully reduce symptoms of TED and may be a reliable tool in the treatment of TED as a relatively safe, fast-acting, efficacious treatment option, particularly as a bridge to other therapies. |
| first_indexed | 2024-03-08T17:07:43Z |
| format | Article |
| id | doaj.art-61821c674322457babcaa0f9f95037c6 |
| institution | Directory Open Access Journal |
| issn | 2674-0826 |
| language | English |
| last_indexed | 2024-03-08T17:07:43Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Ophthalmology |
| spelling | doaj.art-61821c674322457babcaa0f9f95037c62024-01-04T04:30:34ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262024-01-01310.3389/fopht.2023.12960921296092Orbital corticosteroid injections for the treatment of active thyroid eye diseaseKevin T. Eid0Kevin T. Eid1Peter M. Kally2Peter M. Kally3Alon Kahana4Alon Kahana5Alon Kahana6Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, United StatesDepartment of Ophthalmology, University of Utah Moran Eye Center, Salt Lake City, UT, United StatesDepartment of Facial Plastic Surgery, Virginia Mason Franciscan Health, Seattle, WA, United StatesDepartment of Ophthalmology, William Beaumont Hospital, Royal Oak, MI, United StatesDepartment of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, United StatesDepartment of Ophthalmology, William Beaumont Hospital, Royal Oak, MI, United StatesKahana Oculoplastic and Orbital Surgery, Ann Arbor, MI, United StatesPurposeTo study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.MethodsPatients that received orbital injection(s) of triamcinolone acetonide mixed 1:1 with dexamethasone for thyroid eye disease were included in this retrospective study. Demographic and clinical data were collected from the pre-treatment and 1 month follow up evaluations. Clinical data included subjective pain and diplopia scores, best-corrected visual acuity, Intraocular pressure, extraocular motility, clinical activity score, Hertel exophthalmometry, and upper eyelid margin to reflex distance.ResultsFifteen patients, 33 orbital injections, were included in the study. The average patient age was 59.2 years (SD ± 13.0) and 89% female. Subjectively, 67% of patients reported improvement of orbital pain and pressure versus 28% stable and 5% worse (p <0.001). Post-procedure clinical activity score decreased from 3.84 to 3.00 (p = 0.0004). There were no significant differences in upper eyelid margin to reflex distance (4.1 ± 1.4 mm vs. 4.3 ± 2.6 mm, p = 0.45), Hertel exophthalmometry (21.7 ± 9.4 mm vs. 21.8 ± 7.6 mm, p = 0.56), or extraocular motility (21% improved vs. 72% stable and 7% worsening, p = 0.50). No steroid-responsive increases in intraocular pressure or injection-related complications were reported.ConclusionOrbital steroid injections can successfully reduce symptoms of TED and may be a reliable tool in the treatment of TED as a relatively safe, fast-acting, efficacious treatment option, particularly as a bridge to other therapies.https://www.frontiersin.org/articles/10.3389/fopht.2023.1296092/fullgraves orbitopathycorticosteroidorbitalthyroidKenalogclinical activity |
| spellingShingle | Kevin T. Eid Kevin T. Eid Peter M. Kally Peter M. Kally Alon Kahana Alon Kahana Alon Kahana Orbital corticosteroid injections for the treatment of active thyroid eye disease Frontiers in Ophthalmology graves orbitopathy corticosteroid orbital thyroid Kenalog clinical activity |
| title | Orbital corticosteroid injections for the treatment of active thyroid eye disease |
| title_full | Orbital corticosteroid injections for the treatment of active thyroid eye disease |
| title_fullStr | Orbital corticosteroid injections for the treatment of active thyroid eye disease |
| title_full_unstemmed | Orbital corticosteroid injections for the treatment of active thyroid eye disease |
| title_short | Orbital corticosteroid injections for the treatment of active thyroid eye disease |
| title_sort | orbital corticosteroid injections for the treatment of active thyroid eye disease |
| topic | graves orbitopathy corticosteroid orbital thyroid Kenalog clinical activity |
| url | https://www.frontiersin.org/articles/10.3389/fopht.2023.1296092/full |
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