Orbital steroid injection versus orbital radiation therapy in treatment of active thyroid eye disease.

El-Matbouly Saber, Essam Mohamed; Abdou Elgazzar, Hamdy Ahmed; Ateya, Tarek Nehad; Taher Salem, Sameh Galal; Mohamed Abdelbaky El Shabrawy, Ahmed Nassef

doi:10.21608/bmfj.2024.234196.1890

Orbital steroid injection versus orbital radiation therapy in treatment of active thyroid eye disease.

Document Type : Original Article

Authors

¹ Department of Ophthalmology, Faculty of Medicine - Benha University

² Research Institute of Ophthalmolgy, Giza

³ Ophthalmology department, faculty of Medecine,.Benha university, Benha , Egypt

10.21608/bmfj.2024.234196.1890

Abstract

ABSTRACT
Background: Thyroid eye disease is an autoimmune disorder of the retrobulbar tissue. Various treatment modalities are available as peribulbar steroid injection and orbital radiotherapy. Orbital decompression is needed when no improvement after conservative treatment is observed in the inactive phase of the disease.
Aim and objectives: To compare the efficacy and safety of orbital steroid injection versus orbital radiotherapy in treating patients with active thyroid eye disease by clinical activity score system.
Subjects and methods: This is a prospective interventional non-randomized comparative study that was conducted on 30 orbits in patients with active thyroid eye disease attending the outpatient ophthalmology clinic of Benha University and Research insititute of ophthalmology in Giza in the period from march 2021 till May 2023. Radiation therapy was conducted at El-Salam Oncology Center in El-Salam city.
Results:There were significant improvement of proptsosis,CAS and upper lid retraction in both groups,There was significant improvement of VA and motility in radiotherapy group. There was no significant improvement of extraocular muscle thickeness in both groups.
Conclusion:Both peribulbar steroid injection and radiation therapy are effective procedures for the management of active thyroid eyed disease.Radiation therapy resulted in more significant improvement of both visual acuity and proptosis than peribulbar steroid injection. Both groups showed significant improvement of CAS and upper lid retraction with more improvement in the radiotherapy group.Group II showed significant improvement of the degree of motility restriction by Hess screen mainly in adduction and elevation.Both groups showed minimal effect regarding extraocular muscles thickeness after treatment.

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