Orbital steroid injection versus oral steroid therapy in management of thyroid-related ophthalmopathy

P>Background: The aim of this study was to evaluate the efficacy, safety and complications of orbital steroid injection versus oral steroid therapy in the management of thyroid-related ophthalmopathy. Methods: A total of 29 patients suffering from thyroid ophthalmopathy were included in this study. Patients were randomized into two groups: group I included 15 patients treated with oral prednisolone and group II included 14 patients treated with peribulbar triamcinolone orbital injection. Only 12 patients in both groups (16 female and 8 male) completed the study. Results: Both groups showed improvement in symptoms and in clinical evidence of inflammation with improvement of eye movement and proptosis in most cases. Mean exophthalmometry value before treatment was 22.6 +/- 1.98 mm that decreased to 18.6 +/- 0.996 mm in group I, compared with 23 +/- 1.86 mm that decreased to 19.08 +/- 1.16 mm in group II. Mean initial clinical activity score was 4.75 +/- 1.2 and 5 +/- 1.3 for group I and group II before treatment, respectively, which dropped to 0.83 +/- 1.2 and 0.83 +/- 1.02, 6 months after treatment, respectively. There was no change in the best-corrected visual acuity in both groups. There was an increase in body weight, blood sugar, blood pressure and gastritis in group I in 66.7\%, 33.3\%, 50\% and 75\%, respectively, compared with 0\%, 0\%, 8.3\% and 8.3\% in group II. No adverse local side effects were observed in group II. Conclusion: Orbital steroid injection for thyroid-related ophthalmopathy is effective and safe. It eliminates the adverse reactions associated with oral corticosteroid use.