Comparative study of Botox® injection treatment for upper eyelid retraction with 6-month follow-up in patients with thyroid eye disease in the congestive or fibrotic stage

Costa, Pedro Jorge Cavalcante; Saraiva, Fábio Petersen; Pereira, Ivana Cardoso; Monteiro, Mário Luiz Ribeiro; Matayoshi, Suzana

doi:10.1038/eye.2008.165

Cited by 56 publications

(31 citation statements)

References 15 publications

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“…Costa et al prospectively studied UER in TED patients treated with BTA, comparing outcomes in patients in the active and inactive phases of the disease 48. They found significant improvement in UER in both groups, with a palpebral fissure height decrease by 3.05 mm in the active group and 3.81 mm in the inactive group.…”

Section: Resultsmentioning

confidence: 99%

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED)

et al. 2017

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Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal.

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Section: Resultsmentioning

confidence: 99%

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED)

et al. 2017

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“…The fibrotic phase required the absence of inflammatory signs and at least 6 months of stable thyroid hormones. 9 Patients who needed systemic steroid treatments were excluded. Changes in the lid parameters after the injection were evaluated separately between those in the congestive phase and those in the fibrotic phase using the ImageJ program 1.42 (National Institutes of Health, Bethesda, MD).…”

Section: Methodsmentioning

confidence: 99%

“…8,9 The management of the upper lid retraction during the congestive phase of TED is usually limited to conservative treatment. A peribulbar injection of triamcinolone could reduce the inflammatory signs of TED; however, this method is not effective in the lid retraction.…”

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confidence: 99%

Subconjunctival Injection of Triamcinolone for the Treatment of Upper Lid Retraction Associated With Thyroid Eye Disease

Lee¹,

Lee²,

Park³

et al. 2012

Journal of Craniofacial Surgery

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Management of retraction of the upper lid during the congestive phase of thyroid eye disease is usually limited to conservative treatment. We evaluated the efficacy of subconjunctival injection of triamcinolone for the treatment of the upper lid retraction associated with thyroid eye disease.Thirty patients (43 eyes, 11 men and 19 women) with the upper lid retraction associated with thyroid eye disease were evaluated between May 2009 and September 2010. A dose of 0.5 mL of triamcinolone acetonide (40 mg/mL) was injected into the subconjunctival space at the upper margin of the tarsus. If the upper lid retraction had not improved or was still severe 2 weeks after the initial injection, then triamcinolone was injected repeatedly at 2-week intervals. Photographs were taken before the injection and at the follow-up visit, and lid parameters including marginal reflex distance 1, interpalpebral fissure height, total palpebral fissure area, the upper nasal palpebral fissure area, and the upper temporal palpebral fissure area were measured. Changes in the lid parameters after the injection were evaluated.The mean number of injections per patient was 2.67, and the mean (SD) follow-up period was 260.97 (91.10) days. All lid parameters improved significantly after the triamcinolone injection (all P's < 0.05). Nineteen of 22 patients in the congestive phase responded to the triamcinolone injection; however, 6 of 8 patients in the fibrotic phase did not respond to the triamcinolone injection. Complications associated with the triamcinolone injection included an increased intraocular pressure (2 patients) and a mild ptosis (1 patient).The subconjunctival triamcinolone injection is a simple and effective treatment option for the upper lid retraction associated with thyroid eye disease, and this treatment is more effective for the patients in the congestive phase.

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“…In addition, the study by Costa et al found the lid lowering effects of Btx-A lasted longer in patients with fibrotic-stage TED as compared to patients with congestive-stage TED 40 .…”

Section: Induce Ptosis/reduce Lid Retractionmentioning

confidence: 98%