September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Pilot study to assess the efficiency and safety of the parabulbar triamcinolone for the treatment of moderate to severe Graves Ophthalmopathy assessed through STIR magnetic resonance imaging.
Author Affiliations & Notes
  • tomas - ortiz basso
    Ophthalmology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
    Centro Oftalmologico, Santa Rosa, La Pampa, Argentina
  • Rodolfo Luis Vigo
    Ophthalmology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • Mariano - Sidelnik
    diagnostic imaging, Hospital Italiano de Buenos Aires, Buenos aires, Argentina
  • Eduardo Jorge Premoli
    Ophthalmology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • Felisa Shokida
    Ophthalmology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • Footnotes
    Commercial Relationships   tomas ortiz basso, None; Rodolfo Vigo, None; Mariano Sidelnik, None; Eduardo Premoli, None; Felisa Shokida, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5994. doi:
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      tomas - ortiz basso, Rodolfo Luis Vigo, Mariano - Sidelnik, Eduardo Jorge Premoli, Felisa Shokida; Pilot study to assess the efficiency and safety of the parabulbar triamcinolone for the treatment of moderate to severe Graves Ophthalmopathy assessed through STIR magnetic resonance imaging.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5994.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The efficiency of the parabulbar triamcinolone for treating the Thyroid – Associated Ophthalmopathy (TAO) is a controversial issue. We performed a quasi – experimental prospective study to assess if the parabulbar triamcinolone is effective and safe so as to decrease the orbital inflammation in patients presenting moderate to severe TAO.

Methods : It was carried out on patients who suffered from a moderate to severe active Thyroid – Associated Ophthalmopathy.
Through orbital STIR magnetic resonance imaging it was assessed whether the Signal Intensity Ratio (SIR) of the extraocular muscles decreased after a treatment with parabulbar acetonide triamcinolone. Furthermore, the Clinical Activity Score (CAS) was analyzed together with the exophthalmometry, before and after the treatment.
Criteria to exclude patients from the treatment were applied to those suffering from orbitopathy of other ethiology, who had undergone surgery during the 6 previous months, those treated with local or systemic corticosteroids during the 6 previous months. A T – test for paired data was used for statistical analysis.

Results : There were included 15 patients and 28 orbits for the analysis. The average age was 42 years (SD 15,47) and 66% (n10) were women.
The average SIR for the inferior rectus was 4.07 (SD 1.4) before the treatment and 2.67 (SD 0.93) (p 0.0003) after it; in the case of the superior rectus the average SIR was 3.57 (SD 0.86) and 2.8 (SD 0.44) (p 0.0002) after the treatment; in the case of the external rectus that value was 3.65 (SD 0.76) before the treatment and 2.8 (SD 0.4) (p 0,0002) after the treatment; and finally, for the internal rectus the average SIR was 3.93 (SD 1.1) before the treatment and 3.1 (SD 0.58) (p 0.0026) after the treatment.
No patient presented local or systemic complications after the treatment.

Conclusions : The treatment with parabulbar triamcinolone is effective and safe do decrease SIR in patients presenting moderate to severe thyroid-associated ophthalmopathy.
Although further studies are necessary to compare the efficiency and safety of local and systemic corticosteroids applying this technique, they can be effectively replaced when the risk of systemic corticosteroids are greater than the benefits.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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