Document Detail


Repeated peribulbar injections of triamcinolone acetonide: a successful and safe treatment for moderate to severe Graves' ophthalmopathy.
MedLine Citation:
PMID:  18937809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In this study, we aimed to evaluate the efficacy of peribulbar triamcinolone injections to treat inflammatory signs of Graves' ophthalmopathy (GO) in patients with moderate to severe GO and associated optic neuropathy (ON). METHODS: Twenty-one patients with active GO [clinical activity score (CAS) > or = 4] and systemic thyroid disease under control were enrolled in this prospective pilot study. Peribulbar triamcinolone acetonide was injected in each orbit (42 eyes), in four doses of 20 mg at 2-week intervals. Ophthalmological examination including CAS evaluation, visual field, computerized tomography (CT) scan and digital photography were performed before and after treatment. RESULTS: Twenty-one patients (11 with moderate disease, 10 with ON) were enrolled in this study and followed for at least 14 months. Initial mean CAS was 6.38 +/- 1.49, which dropped to 1.8 +/- 1.12 after 6 months of treatment (P = 0.01; mean difference of 4.57 +/- 1.56; range 1-8 score points). ON was diagnosed in 10 patients. Of these, 66% improved with peribulbar triamcinolone exclusively. A transitory increase in intraocular pressure in two patients was controlled with topic medication. CONCLUSION: Peribulbar triamcinolone injections reduce the inflammatory signs of moderate GO, as measured by the CAS, and could also be used as an alternative treatment for ON. Randomized clinical trials are needed to compare the results of triamcinolone peribulbar injections to those of other treatment modalities.
Authors:
Marcela Bordaberry; Daniela L Marques; Julio C Pereira-Lima; Italo M Marcon; Helena Schmid
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-10-07
Journal Detail:
Title:  Acta ophthalmologica     Volume:  87     ISSN:  1755-3768     ISO Abbreviation:  -     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-30     Completed Date:  2009-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  58-64     Citation Subset:  IM    
Affiliation:
Ophthalmology Department, Santa Casa Hospital, Porto Alegre, Brazil. mbordaberry@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Glucocorticoids / administration & dosage*
Graves Ophthalmopathy / drug therapy*,  radiography
Humans
Injections
Intraocular Pressure / drug effects
Male
Middle Aged
Optic Nerve Diseases / drug therapy*,  radiography
Orbit
Pilot Projects
Prospective Studies
Retreatment
Tomography, X-Ray Computed
Treatment Outcome
Triamcinolone Acetonide / administration & dosage*
Visual Fields / drug effects
Chemical
Reg. No./Substance:
0/Glucocorticoids; 76-25-5/Triamcinolone Acetonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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