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Ocular Therapeutic Delivery and Advanced Tissue Retrieval in Adult Rats

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Intraorbital Steroid Injection for Active Thyroid Ophthalmopathy.

Abbas Bagheri^1,2, Mohammad Abbaszadeh², Shahin Yazdani^1,2

¹Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Journal of Ophthalmic & Vision Research

|February 26, 2020

Summary

Orbital steroid injections effectively treat active thyroid ophthalmopathy in patients unresponsive to systemic steroids. This method improved clinical activity scores and lid retraction, offering a viable alternative treatment.

Keywords:

Lid Retraction Orbital Inflammation Proptosis Steroid Injection Graves

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Area of Science:

Ophthalmology
Endocrinology

Background:

Thyroid ophthalmopathy (TO) is an autoimmune condition affecting the eye socket.
Systemic steroids are a common treatment but can lead to resistance, dependence, or complications.

Purpose of the Study:

To assess the efficacy of orbital steroid injections for active thyroid ophthalmopathy.
To evaluate this treatment in patients with systemic steroid resistance, dependence, or complications.

Main Methods:

A prospective case series of 17 patients (31 eyes) with active TO (Clinical Activity Score [CAS] ≥ 3).
Retroseptal injections of triamcinolone acetonide and dexamethasone were administered 3-4 times at monthly intervals.
Patients were monitored post-injection and for at least three months after the final dose.

Main Results:

Mean CAS significantly decreased from 5.2 to 1.6 post-treatment (P < 0.001).
100% improvement in upper lid retraction and 68.2% in lower lid retraction were observed.
Exophthalmos improved by 1.2 mm; strabismus resolved in one patient. Ocular side effects were minimal.

Conclusions:

Orbital steroid injections are a safe and effective treatment for active thyroid ophthalmopathy.
This approach is particularly beneficial for patients with resistance or adverse effects from systemic steroids.