甲状腺眼症へのtriamcinolone acetonide眼窩内局所投与の効果

Effects of triamcinolone acetonide orbital injection on thyroid ophthalmopathy

（P−166）　甲状腺眼症に対して，懸濁糖質副腎皮質ホルモン剤であるトリアムシノロン（triamcinolone ace—tonide）の眼窩内注射療法の効果を検討した。症例は13例25眼で，眼症が無治療の群，副腎皮質ステロイド薬のみの群，ステロイドパルス療法と放射線照射群に分け，それぞれにトリアムシノロンの眼窩内注射を合計4回行った。自覚症状と他覚的所見を治療開始前と終了後3か月で評価した。眼瞼腫脹はほとんどの例で改善し，痛み，複視も軽減した。他覚的所見である眼球突出，眼球運動障害，外眼筋肥厚の顕著な改善はなかった。本治療による重篤な副作用はなかった。以上，トリアムシノロン注射で劇的な改善効果はなかったが，患者の満足は得られた。本薬剤は徐放薬で持続性があるので，ステロイド緑内障について注意が必要である。

We evaluated the effect of triamcinolone acetonide on thyroid-associated ophthalmopathy when injected intraorbitally as carbohydrate suspension. The subjects comprised 25 eyes of 13 patients. They were divided into 3 groups based on past treatments: untreated, corticosteroid pulse therapy, and radiation with corticosteroid pulse ther-apy. They were evaluated before and 3 months after end of treatment.Subjective symptoms improved in most cases in-cluding eyelid swelling, ocular pain, and diplopia. No improvement was found in objective findings, including exophthal-mos, eye movement, and hypertrophy of external ocular muscles. There were no significant side effects throughout. The findings show that this therapeutic modality resulted in no dramatic improvement but that the patients were sat-isfied with the outcome. Due precaution is required regarding corticosteroid glaucoma as this preparation is slow-act-ing and persistent.