Peri‐levator palpebrae superioris triamcinolone injection for the treatment of thyroid eye disease‐associated upper eyelid retraction

Joos, Zachary; Sullivan, Tim

doi:10.1111/ceo.12939

Cited by 15 publications

(6 citation statements)

References 5 publications

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“…Peribulbar and sub‐conjunctival steroids have also been used for upper eyelid retraction in TED . Studies show that repeat injections of 20 mg of TA are required (one to four injections at monthly intervals) and the response rate is better in patients with recent onset of upper lid retraction or active disease.…”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

“…Xu et al noted an improvement in 83.3% of patients with symptom duration less than 6 months, compared to 36.4% who responded if symptoms were greater than 6 months. Joos et al showed that a superior orbital peri‐levator injection technique improved lid retraction and demonstrated reduction in size of the levator/superior rectus complex on MRI imaging after repeat injections.…”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

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Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…TA is a long-acting uorinated glucocorticoid that has anti-in ammatory effects on the superior eyelid muscle (levator muscle) and Müller's muscle. It also plays a role in degenerative changes in the superior eyelid muscle tendon, which causes it to peel away from the tarsus, leading to Müller's muscle atrophy [2,21]. Young et al found that TA injection therapy can be used as the primary treatment for patients receiving only TA injections or as an adjunct treatment for patients previously receiving systemic immunosuppressive therapy, both of which are effective, but may require repeated injections to achieve optimal control[8].…”

Section: Results 1 Comparison Of General Data Before Injectionmentioning

confidence: 99%

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

Huang,

Xu,

Zhang

et al. 2024

Preprint

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Purpose To observe the therapeutic effect of subconjunctival injection of botulinum toxin A (BTX-A) combined with periorbital injection of triamcinolone acetonide (TA) in the treatment of upper eyelid retraction (UER) caused by thyroid-associated ophthalmopathy (TAO). Methods Fifty eyes diagnosed with TAO-associated UER were divided into two groups. Group 1 received TA periorbital injection, while group 2 received BTX-A subconjunctival injection combined with TA periorbital injection. Marginal reflex distance (MRD1) and graine sign (GS) were assessed at baseline and at various time points post-injection. The incidence of elevated intraocular pressure was also observed. Results Group 1 showed significant decrease in MRD1 at 1, 3, and 6 months post-injection (P < 0.05) and increase in GS at 3 months post-injection (P < 0.05). Group 2 showed significant decrease in MRD1 at 1w, 1, 3, and 6 months post-injection (P < 0.05) and increase in GS at 1w, 1, and 3 months post-injection (P < 0.05). After one week of the first injection, group 2 had lower MRD1 and higher GS values than group 1 (P < 0.001 and P = 0.013, respectively). The incidence of elevated IOP was significantly lower in group 2 than in group 1 (P < 0.05). Conclusion In a six-month study, patients with TAO related UER treated with BTX-A and TA demonstrated a faster onset of therapeutic effect compared to those treated with TA alone. This combined treatment approach sustained stable efficacy with a reduced dosage of local steroid and a lower incidence of intraocular pressure elevation. Trial registration number: ChiCTR2300077958

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“…While studying the impact of upper and lower forniceal TA injection on TED activity, Hamed-Azzam et al observed that 77.7% of the TED patients with UER showed improvement, although measurements and information about the duration of the effect were not mentioned 57. Recently, Joos and Sullivan shared their experience with percutaneous TA injections in active TED patients 58. Using similar doses, the authors reported effective results in early congestive cases with no secondary IOP elevation.…”

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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Peri‐levator palpebrae superioris triamcinolone injection for the treatment of thyroid eye disease‐associated upper eyelid retraction

Cited by 15 publications

References 5 publications

Local delivery of corticosteroids in clinical ophthalmology: A review

Local delivery of corticosteroids in clinical ophthalmology: A review

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

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

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