Effectiveness of triamcinolone acetonide injection for upper eyelid retraction and excursion in active thyroid eye disease.

Objective: To evaluate the efficacy and safety of a triamcinolone acetonide (TA) injection for upper eyelid retraction and excursion in patients with active thyroid eye disease (TED).

Design: A retrospective observational study.

Participants: Fifty-six eyelids of 42 patients with TED who had magnetic resonance imaging-confirmed inflammation of the levator palpebrae superioris (LPS), with or without lacrimal gland (LG) involvement.

Methods: Each patient received a transcutaneous injection of 1 mL of TA (40 mg/mL). Clinical outcomes included margin reflex distance-1 (MRD-1), upper eyelid excursion, Hertel exophthalmometry, and clinical activity score (CAS), recorded at baseline, 2 months, and 6 months postinjection. Intraocular pressure (IOP) and adverse events were monitored. Outcomes were compared between patients with inflammation localized in the LPS muscle (LPS group) and those with LPS inflammation, extending to the lacrimal gland (LPS-LG group).

Results: All variables improved by 2 months postinjection, and MRD-1 significantly decreased from 5.8 mm at baseline to 4.5 mm at 6 months (p < 0.001). Upper eyelid excursion improved from 12.8 mm to 14.5 mm (p < 0.001). Hertel exophthalmometric values were reduced (16.8 mm to 16.4 mm; p = 0.007). CAS decreased significantly from 1.7 to 0.1 (p < 0.001). No significant differences in treatment outcomes were observed between the LPS and LPS-LG groups. No cases of IOP elevation or post-procedural complications were observed.

Conclusions: A transcutaneous TA injection effectively improves upper eyelid retraction and excursion in active TED without significant adverse events.