金　晶，项　楠，刘　荣，胡维琨

作者单位：1(443000)中国湖北省宜昌市，三峡大学第一临床医学院 宜昌市中心人民医院眼科；2(430030)中国湖北省武汉市，华中科技大学同济医学院附属同济医院眼科



·临床报告·

球旁注射曲安奈德在甲状腺相关性眼病中的疗效观察

金晶1，项楠2，刘荣2，胡维琨2

作者单位：1(443000)中国湖北省宜昌市，三峡大学第一临床医学院 宜昌市中心人民医院眼科；2(430030)中国湖北省武汉市，华中科技大学同济医学院附属同济医院眼科

Therapeutic effect of periorbitally injected triamcinolone acetonide for thyroid-associated ophthalmopathy

Jing Jin1, Nan Xiang2, Rong Liu2, Wei-Kun Hu2

1Department of Ophthalmology, Affiliated Yichang Central People’s Hospital, the First Clinic College of Three Gorges University, Yichang 443000, Hubei Province, China;2Department of Ophthalmology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China

Correspondence to:Jing Jin. Department of Ophthalmology, Affiliated Yichang Central People’s Hospital, the First Clinic College of Three Gorges University, Yichang 443000, Hubei Province, China. 357601801@qq.com

Received：2015-12-30Accepted：2016-03-10

Abstract

•AIM:To evaluate the therapeutic effect of periorbitally injected triamcinolone acetonide(TA) for thyroid-associated ophthalmopathy.

•METHODS:Thirty-six patients(60 eyes) diagnosed as thyroid-associated disease by many related academics were collected in the past two years, 12 male(18 eyes) and 24 female(42 eyes), 12 cases with monocular, 24 with binocular, aged 23～40 years, mean 33±5 years. Their course of diseases were 2mo～4a, mean 15mo.The therapy of TA:20mg for each eye once, every 3～4wk, 3～4 times as one course. The injection point and method:the patient took the supine position, the skin around the ocular was disinfected twice with entoiodine;the patient was asked to look upward, the needle entered at the 1/3 lateral-mid point;then the needle reached the equator along the paries superior orbitae;after that, the direction of the needle changed to slightly towards inferior nasal;the depth was about 35mm;the patient was asked to move his eyeball towards different directions;1mL of the medicine was injected to the retrobulbar after making sure the eyeball was not injured and no blood in the syringe if its plunger was draw back;sterile gauze was pressed against the eyeball and make sure there was no hemorrhage or other discomforts. Observation for the therapeutic effect, including the improvement of eye symptoms and signs, after one course.

•RESULTS:TA had a significant efficience for relieving phengophobia(χ2=19.326,P<0.01),epiphora(χ2=8.500,P<0.01),eye-bulging(χ2=8.500,P<0.05), sensation of dryness(χ2=8.025,P<0.01), eyelid-swollening(χ2=8.743，P<0.01), but ocular movement, diplopia and Von Graefes symptom were not improved(separatelyPwere 0.144,0.530,0.589, allP>0.05).Besides, protopsis(16.082±2.503mm) as compared to(16.875±3.143mm) and Dalrymple symptom(0.950±1.167mm) as compared to(3.100±1.633mm) were exactly improved(P<0.01) after treatments.But intraocular pressure(IOP) of our group did not increase before and after treatments(P=0.081).

•CONCLUSION:Periorbitally injected TA can improve protopsis，Dalrymple symptom and local ocular symptoms, and all patients we treated were at an normal IOP. But ocular movement, diplopia and Von Graefes symptom were not improved.

KEYWORDS:•periorbital injection:triamcinolone acetonide;thyroid-associated ophthalmopathy

Citation:Jin J, Xiang N, Liu R,etal. Therapeutic effect of periorbitally injected triamcinolone acetonide for thyroid-associated ophthalmopathy.GuojiYankeZazhi(IntEyeSci) 2016;16(4):779-781

摘要

关键词：球旁注射；曲安奈德；甲状腺相关性眼病

引用：金晶，项楠，刘荣，等.球旁注射曲安奈德在甲状腺相关性眼病中的疗效观察.国际眼科杂志2016;16(4):779-781

0引言

甲状腺相关性眼病(thyroid-associated ophthalmopathy, TAO) 是眼科最常见的眼眶病之一，也是成人眼球突出的常见原因。从发现至今已有200多年的历史。过去命名较多，如甲状腺眼病、甲状腺毒性眼病、内分泌眼肌病变、内分泌性眼球突出、眼球突出性甲状腺肿、恶性突眼和浸润性突眼[1-2]。目前公众比较认可甲状腺相关性眼病的说法。习惯上，眼科医生将甲状腺功能异常伴有眼部症状的患者叫Graves’眼病；而将甲状腺功能正常，甲状腺不肿大，各种化验检查正常而只有眼部症状的称为眼型Graves’病。大约有20%～25%的甲状腺相关性眼病患者伴有甲状腺功能亢进[3]。到目前为止，涌现很多关于TAO治疗方法以及疗效方面的文章，但是对于TAO相关症状和体征的改善情况欠缺描述和分析。本文针对近2a来我院就诊的TAO患者进行回顾性分析，旨在探讨曲安奈德(TA)对于TAO患者的疗效情况。……