Therapeutic Effects of Periocular Injection of Triamcinolon Acetonide in Patients with Thyroid-Associated Ophthalmopathy

PURPOSE: The present study investigated the therapeutic effects of periocular triamcinolone acetonide injections to treat inflammatory signs in patients with severe acute thyroid-associated ophthalmopathy. METHODS: Twenty-two patients with symptoms of severe acute thyroid ophthalmopathy were enrolled in the present study. The patients received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The changes in visual acuity, intraocular pressure, eye ball motility, exophthalmos, thickness of extraocular muscles, clinical activity score and NOSPECS score were measured. RESULTS: Eighteen of 22 patients (81.8%) showed improvement in soft tissue swelling, ten patients (45.5%) showed improvement in conjunctival hyperemia and one patient showed improvement of ocular motility. Clinical activity score and NOSPECS score had significant improvements. No patient had changes in visual acuity, intraocular pressure, diplopia, proptosis or thickness of extraocular muscles. An ocular adverse effect was found in one patient, who had subcutaneous fat atrophy at the injection site. CONCLUSIONS: In patients with severe acute thyroid ophthalmopathy, periocular triamcinolone acetonide injection can be effective to improve acute inflammatory symptoms, without significant adverse effects.

The Relationship Between Bagolini Test and Other Sensory Tests and Surgical Outcome of Intermittent Exotropia

PURPOSE: To determine the surgical outcome of intermittent exotropia according to preoperative retinal correspondence with the Bagolini striated glasses test and the relationships between the Worth-4-dot test or stereoacuity with the B-VAT test. METHODS: We analyzed retrospectively preoperative fusion statuses with the Worth-4-dot test, stereoacuity with the B-VAT test and retinal correspondence with the Bagolini striated glasses test to determine any possible relationships with surgical outcome. The surgical outcome and binocular function were further investigated six months postoperatively in 114 patients who had undergone surgery for intermittent exotropia. RESULTS: The surgical outcome according to preoperative fusion status and stereoacuity was not statistically significant(p=0.38, p=0.59). whereas, preoperative retinal correspondence with the Bagolini striated glasses test was statistically significant(p<0.01). More over there was a relationship between retinal correspondence and fusion status or stereoacuity(p<0.01, p<0.01). CONCLUSIONS: The preoperative Bagolini striated glasses test was the factor predicting a favorable surgical outcome and there was a relationship between the preoperative Worth-4-dot test and the B-VAT test.

The Refractive Change After Cataract Surgery in Patients With Acute Primary Angle Closure

PURPOSE: To evaluate the change of postoperative refraction after cataract surgery in patients with a history of acute primary angle closure. METHODS: A survey was conducted on 40 eyes of 40 patients who underwent cataract surgery with a history of acute primary angle closure, and 40 eyes of 40 patients who underwent cataract surgery only during the follow-up period of six months. We reviewed changes in the postoperative refraction and compared the difference between the postoperative spherical equivalent and target refraction in both groups. RESULTS: In the group with a history of acute primary angle closure, target refraction was -0.20+/-0.27D and the six months postoperative spherical equivalent was -0.76+/-1.12D. In the group with cataract only, target refraction was -0.30+/-0.20D and the six months postoperative spherical equivalent was -0.22+/-0.57D. In the group with the history of acute primary angle closure, the postoperative refraction shifted to myopic refractive power significantly. CONCLUSIONS: In cataract patients with a history of acute primary angle closure, there was a myopic shift in postoperative refraction after cataract surgery. Therefore, this finding should be considered during cataract surgery.