title: Orbital steroid injection versus oral steroid therapy in management of thyroid-related ophthalmopathy.
abstract: 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.
  
  
  CONCLUSIONS
  Orbital steroid injection for thyroid-related ophthalmopathy is effective and safe. It eliminates the adverse reactions associated with oral corticosteroid use.
authors.affiliation: Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt. aymanalkawas@yahoo.com
authors.forename: Ayman A
authors.initials: AA
authors.lastname: Alkawas
authors.forename: Atef M
authors.initials: AM
authors.lastname: Hussein
authors.forename: Ezzat A
authors.initials: EA
authors.lastname: Shahien
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005094:Exophthalmos / Q000139:chemically induced; D005133:Eye Movements / Q000187:drug effects; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D049970:Graves Ophthalmopathy / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007267:Injections; D008297:Male; D009915:Orbit; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011239:Prednisolone; D014222:Triamcinolone Acetonide