The Clinic Study Of The Upper Fornical Conjunctive Injection Of Traimcinolone On Upper Lid Retraction Of Thyoid Associated Ophthalmopathy

Objective To report the effect of steroid with different apporoach on thyriod associated ophthalmopathy(TAO)patients who the mainly sign is upper lid retraction ,it will supply an ideal therapy scheme for the upper lid retraction of TAO.Methods We selected 74 patients who had upper lid retraction of TAO among 246 consecutive patients .Acording to the functional status of thyriod and the course of the disease,we divided the patients into three groups. All the patients were injected triamcinolone 0.8ml in upper fornical conjunctive, 1 time per week,keep on 7 weeks. The first group received only upper fornical conjunctive injection therapy.The second group were pulsed the treatment of oral triamcinolone tablets 40mg,decrease as routine way until 8mg,keeping on 50 days. The third group taking orally Thiamazole 10mg and Euthyrox 12.5ug until 6 months as a addition of the schedule 2.The classification activity score(CAS),eyelids height,upper eyelid lag were documented every week,the observing time is 3 month and 6 month after therapy.Results 1)In the 7 week after the therapy,the decreasing height of eyelids in the three groups mean value by turns is 1.65±0.98mm,1.44±0.64 mm,1.56±0.73mm(p<0.01).The decreasing of upper eyelid lag in the three groups mean value by turns is 0.76±0.54mm,0.72±0.41mm, 0.81±0.53mm.The decreasing score of CAS in the three groups mean value by turns is 3.90±1.37 3.97±1.30 4.15±1.46(P<0.01).2)In the month 3,there are no significant difference about the effect on upper lid retraction of TAO between the group land group 2,3.(x~2=0.68,p>0.25,x~2=0.10,p>0.25)).In the month 6,there are aslo have no significant effect between the group 1 and group 2,3.(x~2=0.72,p >0.25,x~2=0.10,p>0.25)3) After oraling Triamcinolone tablets,6 cases presented mild stomach ache,Increased body weight .1 case appeared skin eruption in all body after oraling Thiamazole.2 cases eye intraocular pressue steped up.Conclusions Our therapy scheme can improve the upper lid retraction and upper eyelid lag about the patients of TAO,and aslo can decrease clincal activity sore of TAO,relive the symptoms of ocular surface. Camparing the group of only upper fornical conjunctive injection,the groups of plusing oral steroids have no significant effect on upper lid retraction of TAO.