Subconjunctival injection of triamcinolone in the treatment of lid retraction of patients with thyroid eye disease: a case series

Chee, Elaine; Chee, Soon-Phaik

doi:10.1038/sj.eye.6702933

Cited by 47 publications

(29 citation statements)

References 7 publications

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“…In addition, the subconjunctival injection into the upper lid may cause detachment of the levator aponeurosis and the Müller muscle from the tarsal plate. 27 Other potential adverse effects associated with triamcinolone, such as cataract and infection, were not observed in our study.…”

Section: Discussionmentioning

confidence: 58%

“…In a recent study, 3 of 4 patients in the congestive phase with upper lid retraction showed a favorable response to the triamcinolone injection; however, 1 patient in the fibrotic phase did not respond to the triamcinolone injections and required surgical correction. 27 The most common adverse effect of triamcinolone injection is an increase in intraocular pressure. 22,28 Topical steroids are more likely to cause an elevation in the intraocular pressure, and a periocular injection of a long-acting corticosteroid is the most dangerous route of administration.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

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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“…Chee et al reported four cases treated with upper eyelid subconjunctival TA injections 53. Three of the four cases achieved resolution of retraction, eyelid position normalisation, seen in 6 to 12 months.…”

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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“…In ophthalmology, subconjunctival TA has been used for anterior scleritis, 21 , 22 pterygium surgery, 23 superior limbic keratoconjunctivitis, 24 uveitis, corneal burns and ulcers, 8 intraocular surgery, 8 , 25 and thyroid eye disease 26 . Recently, its use has been reported to successfully reverse corneal graft rejection in posterior lamellar 27 and penetrating keratoplasties 28 …”

Section: Discussionmentioning

confidence: 99%

Subconjunctival Injection of Triamcinolone Acetonide in the Management of Corneal Graft Rejection and New Vessels

Athanasiadis

Wit

Patel

et al. 2012

The Journal of Clinical Pharma

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Subconjunctival injection of triamcinolone in the treatment of lid retraction of patients with thyroid eye disease: a case series

Abstract: Upper lid subconjunctival triamcinolone appears to be an effective treatment option in reducing lid retraction in patients with recent onset of thyroid eye disease.

Cited by 47 publications

References 7 publications

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

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

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

Subconjunctival Injection of Triamcinolone Acetonide in the Management of Corneal Graft Rejection and New Vessels

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