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(separately P were 0.144,0.530,0.589, all P>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.