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Retrobulbar Injection of Triamcinolone in Thyroid Associated Orbitopathy


Anuchit Poonyathalang, MD*, Pisit Preechawat, MD*,
Warangkhana Charoenkul, MD*, Piradee Tangtrakul, MD*

* Department of Ophthalmology, Ramathibodi Hospital Faculty, Mahidol University


Objective: To identify the result of retrobulbar triamcinolone injection in patients with thyroid associated orbitopathy
Material and Method: Prospective noncomparative pilot study in 27 eyes of 19 patients who had been diagnosed as thyroid associated orbitopathy during October 2000 through April 2002. The patients received retrobulbar 40 mg triamcinolone treatment for each orbit weekly, totaling 4 applications.
Results: Three months after treatment, most of the patients demonstrated no significant change in visual acuity and visual field. Improvement of proptosis was observed in 15 eyes (56%) and stable in 10 eyes (37%). Seven patients (41%) had improvement of extraocular muscle function as demonstrated by Hess test. These results remained stable in the majority of patients at the 6 months follow up period. No systemic side effects were observed.The only significant local side-effect was intraocular pressure elevation which was found in 8 eyes and responded to antiglaucoma therapy.
Conclusion: This preliminary study demonstrated the potential benefit of retrobulbar triamcinolone injection in cases of thyroid associated orbitopathy. Long-term study in these patients is required.

Keyword : Triamcinolone, Thyroid, Orbitopathy, Retrobulbar

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