Purchase this article with an account.
Gaku Ito, Ai Kozaki, Kahori Mizuno, Rishu Inoue, Toshu Inoue; Steroid therapy combined intravenous administration and retrobulbar injection for thyroid eye disease with hepatitis B core antibody positive. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4103.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of steroid therapy combined intravenous administration and retrobulbar injection for thyroid eye disease.
Nineteen patients (5 males and 14 females, 61±7 years old ) with thyroid eye disease were enrolled in this study. All patients were hepatitis B core antibody positive. We performed intravenous administration and retrobulbar injection of steroid for thyroid eye disease. The intravenous injection began with betamethasone sodium phosphate 4 mg/day and tapered to 2 mg/day within 2 weeks. A retrobulbar injection of betamethasone sodium phosphate 4 mg/day was performed 7 times each for both eyes. MRI examination was performed before and after 3 months of treatment. Cross-sectional area and signal intensity of extraocular muscles were measured on coronal section of MRI image. The signal intensity ratio of muscles was calculated by normalizing signal intensity.
The value of cross-sectional area before and after treatment were 0.64 ± 0.25 to 0.57 ± 0.25 in inferior rectus muscle (IR), 0.56 ± 0.22 to 0.47 ± 0.18 in medial rectus (MR), 0.46 ± 0.13 to 0.44 ± 0.19 in superior rectus (SR), and 0.44 ± 0.12 to 0.38 ± 0.09 in lateral rectus (LR), respectively. The mean signal intensity ratio before and after treatment was 1.24 ± 0.24 to 0.92 ± 0.27 in IR, 1.26 ± 0.25 to 0.99 ± 0.24 in MR, 1.22 ± 0.27, 0.95 ± 0.33 in SR, and 0.96 ± 0.16 to 0.82 ± 0.10 in LR, respectively. In IR and MR and LR the cross-sectional area was significantly decreased after treatment (IR P= 0.014, MR and LR P<0.01). In all rectus muscles the mean signal intensity ratio was significantly decreased after treatment (P<0.01). In all patients hepatitis associated with steroid therapy did not observed.
Steroid therapy combined intravenous administration and retrobulbar injection is considered effective treatment for thyroid eye disease. This therapy could become a choice of treatment for severe thyroid eye disease with hepatitis B core antibody positive.
This PDF is available to Subscribers Only