https://doi.org/10.31288/oftalmolzh201355760

The results of complex treatment of congestive exophthalmos using retrobulbar injections of prolonged corticosteroids

Nykolyuk AM

Ivano-Frankivsk National Medical University

Introduction. The appropriateness of retrobulbar injections of corticosteroids for the patients with congestive exophthalmos (CE) is controversial due to their lower effectiveness compared to systemic use, however, the latter is limited by numerous contraindications and side-effects.

Purpose — to study the efficacy of conservative treatment with the use of retrobulbar injections of kenalog (triamcinilone) for patients with congestive exophthalmos depending on the stage of CE, in which the treatment was begun. 

Material and methods — 25 patients with the initial stage of CE diagnosed in early terms (1—3 months) owing to regular check-ups, and 28patients with expressed CE were examined and treated. An ophthalmology inspection included the complex of oculometric indexes (degree of upper-eyelid retraction, exophthalmometry, volume of eye movements), visual functions examination and color dopplerography of orbital vessels. The results were evaluated in 6 months. Results. The conducted treatment resulted in decrease of upper eyelid retraction, increase of volume of eye movements in all patients, decrease of exophthalmos in 83—84 % patients, and to improvement of functional and hemodynamic indexes in both investigated groups. Treatment, prescribed in the initial stage of CE was 12—26 % more effective than the one, started at expressed CE.

Conclusions. Treatment with the use of retrobulbar injections of kenalog is reliably effective (p<0.05) in relation to regress of basic symptoms of congestive exophthalmos.

Key words: thyroid ophthalmopathy, congestive exophthalmos, treatment

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