Abstract
Purpose:
To evaluate the effect of steroid therapy combined intravenous administration and retrobulbar injection for thyroid eye disease.
Methods:
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.
Results:
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.
Conclusions:
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.
Keywords: 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials