{"title":"眼眶皮质类固醇注射治疗活动性甲状腺眼病","authors":"Kevin T. Eid, Peter M. Kally, A. Kahana","doi":"10.3389/fopht.2023.1296092","DOIUrl":null,"url":null,"abstract":"To study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.Patients 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.Fifteen 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.Orbital 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.","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Orbital corticosteroid injections for the treatment of active thyroid eye disease\",\"authors\":\"Kevin T. Eid, Peter M. Kally, A. Kahana\",\"doi\":\"10.3389/fopht.2023.1296092\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"To study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.Patients 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.Fifteen 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.Orbital 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.\",\"PeriodicalId\":73096,\"journal\":{\"name\":\"Frontiers in ophthalmology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in ophthalmology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fopht.2023.1296092\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fopht.2023.1296092","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
研究眼眶注射曲安奈德与地塞米松1:1混合液治疗活动性甲状腺眼病的疗效。这项回顾性研究纳入了接受眼眶注射曲安奈德与地塞米松1:1混合液治疗甲状腺眼病的患者。研究人员从治疗前和一个月的随访评估中收集了人口统计学和临床数据。临床数据包括主观疼痛和复视评分、最佳矫正视力、眼压、眼球外运动、临床活动评分、Hertel眼外肌测量和上眼睑边缘至反射距离。患者平均年龄为 59.2 岁(SD ± 13.0),89% 为女性。主观上,67%的患者表示眼眶疼痛和压力有所改善,28%的患者表示稳定,5%的患者表示恶化(P <0.001)。术后临床活动评分从 3.84 降至 3.00(p = 0.0004)。上睑缘到反射的距离(4.1 ± 1.4 mm vs. 4.3 ± 2.6 mm,p = 0.45)、Hertel 眼外测量(21.7 ± 9.4 mm vs. 21.8 ± 7.6 mm,p = 0.56)或眼外运动(21% 改善 vs. 72% 稳定和 7% 恶化,p = 0.50)均无明显差异。眼眶类固醇注射可成功减轻TED的症状,作为一种相对安全、起效快、疗效好的治疗方案,尤其是作为其他疗法的过渡,可能是治疗TED的可靠工具。
Orbital corticosteroid injections for the treatment of active thyroid eye disease
To study the efficacy of orbital injections of triamcinolone acetonide mixed 1:1 with dexamethasone in the treatment of active thyroid eye disease.Patients 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.Fifteen 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.Orbital 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.