The Role of Retrobulbar Triamcinolone Acetonide Injections in Active Thyroid Eye Disease: Clinical Response and Safety Profile
Author: Altug Cetinkaya
Base Hospital / Institution: Yüksek İhtisas Üniversitesi & Private Clinic, Ankara, Türkiye
Abstract ID: 25-557
Purpose
To evaluate the efficacy and safety of retrobulbar triamcinolone acetonide (rTA) injections in patients with active thyroid eye disease (TED), with a focus on their role in modulating disease progression and influencing treatment strategy.
Methods
This prospective study included 25 eyes from 17 patients diagnosed with active-phase TED who received rTA injections between 2019 and 2025. Patients on systemic corticosteroids were excluded. Subjective symptoms (blurred vision, periorbital pressure/pain) and objective findings—including visual acuity (VA), eyelid retraction, lower scleral show, retropulsion, Hertel exophthalmometry, and intraocular pressure (IOP)—were recorded before and one month after each injection. Adverse events were assessed immediately and at follow-up visits. Changes were analyzed using Generalized Estimating Equations, with p<0.05 indicating statistical significance.
Results
The mean patient age was 43.5 ± 11.2 years. A total of 69 injections (0.8–1 ml of 40 mg/ml rTA per session) were administered, with a mean of 2.76 injections per eye. Blurred vision improved in 23.5% and periorbital discomfort in 52.9% after the first injection. Statistically significant reductions in eyelid retraction were observed after the second (p=0.001) and third injections (p=0.03). Hertel measurements increased slightly following the first injection (p=0.027) but remained stable thereafter, suggesting a halt in proptosis progression. No significant changes were noted in lower scleral show, retropulsion, VA, or IOP. Longer disease and symptom duration were negatively correlated with response to treatment. No significant adverse events except for temporary moon-face (1 case) were reported across all treatment sessions.
Conclusion
Retrobulbar triamcinolone acetonide injections are a safe and potentially effective therapeutic option for active TED. Repeated injections can improve eyelid retraction and may stabilize proptosis, particularly when administered early. These findings support the role of rTA in delaying or reducing the need for surgical intervention in selected patients.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Demet | Yabanoğlu | Hacettepe Üniversitesi, Ankara, Türkiye |
