Young Stephanie Ming, Kim Yoon-Duck, Lang Stephanie S, Woo Kyung In
Department of Ophthalmology, National University Hospital, Singapore.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ophthalmic Plast Reconstr Surg. 2018 Nov/Dec;34(6):587-593. doi: 10.1097/IOP.0000000000001120.
To evaluate the role of transconjunctival triamcinolone acetonide (TA) injection in the management of upper eyelid retraction in thyroid eye disease.
Retrospective interventional review of all patients who underwent transconjunctival TA injection (40 mg/mL) for thyroid eye disease-related upper eyelid retraction from January 2010 to December 2016 in a single tertiary institution. The present study comprised 2 groups: Patients receiving only TA injection (group 1), and patients receiving both TA injection and other immunosuppressive therapy (group 2).
There were a total of 99 patients and 135 eyes. Group 1 comprised of 36 eyes (26.7%), while group 2 comprised 99 (73.3%). Normalization or improvement of margin reflex distance 1 was seen in 77.4% and 97.2% of group 1 patients at early and late review, respectively, and 77.6% and 87.8% of group 2, respectively. Absence or improvement in International Thyroid Eye Disease Society inflammatory index was seen in 83.9% and 86.1% of group 1 at early and late review, respectively, and 71.9% and 76.8% of group 2, respectively. Both active (73.7%) and inactive (79.3%) groups showed good early success for improvement in margin reflex distance 1, with increased late success and no significant difference between the groups. For International Thyroid Eye Disease Society inflammatory index, the active group had better early and late success than the inactive group, with the difference being significant (P = 0.002) for late success.
Transconjunctival TA injection is an effective treatment option for thyroid eye disease-related upper eyelid retraction, as a primary and adjunctive treatment, in both active and inactive thyroid eye disease patients.
评估经结膜注射曲安奈德（TA）在甲状腺眼病上睑退缩治疗中的作用。
对2010年1月至2016年12月在一家三级医疗机构接受经结膜TA注射（40mg/mL）治疗甲状腺眼病相关上睑退缩的所有患者进行回顾性干预性研究。本研究分为两组：仅接受TA注射的患者（第1组）和接受TA注射及其他免疫抑制治疗的患者（第2组）。
共有99例患者135只眼。第1组有36只眼（26.7%），第2组有99只眼（73.3%）。在早期复查时，第1组分别有77.4%的患者和晚期复查时97.2%的患者，第2组分别有77.6%和87.8%的患者，其睑缘反射距离1恢复正常或改善。在早期复查时，第1组分别有83.9%的患者和晚期复查时86.1%的患者，第2组分别有71.9%和76.8%的患者，其国际甲状腺眼病学会炎症指数消失或改善。活动期（73.7%）和非活动期（79.3%）两组在改善睑缘反射距离1方面早期成功率均良好，晚期成功率增加且两组间无显著差异。对于国际甲状腺眼病学会炎症指数，活动期组早期和晚期成功率均高于非活动期组，晚期成功率差异有统计学意义（P = 0.002）。
经结膜TA注射是甲状腺眼病相关上睑退缩的一种有效治疗选择，可作为活动期和非活动期甲状腺眼病患者的主要及辅助治疗方法。
