Effect of Intraorbital Steroid Injections on Intraocular Pressure in Thyroid Eye Disease

Purpose: To study the effect of orbital steroid injections administered in the treatment of thyroid eye disease (TED) on intraocular pressure (IOP). Methods: Retrospective chart review of consecutive patients over 70 months with active thyroid eye disease (TED) seen in a referral oculoplastic practice who underwent orbital steroid injections. Results: The clinical records of 56 patients were included in the study. There were 51 females and 5 males; 43 (77%) were Caucasian; the average age was 50 years old. A mean number of 3.5 injections (range 1-12) were given per patient resulting in 91 encounters being examined. Injections consisted of dexamethasone in all cases with addition of betamethasone in 49 cases, methylprednisolone in 3 cases and triamcinolone in 3 cases. Pre-injection intraocular pressure (IOP) was recorded in 42 instances and post-injection IOP was recorded in 26 instances. The average time interval to next follow up was 9.4 weeks and the average time interval to next injection was 17.75 weeks There was no increase in the mean pre-injection vs. post-injection IOP (short-term effect), nor in the firstrecorded vs. last recorded IOP (long-term effect). In 73 instances, subjective response to injections with respect to swelling was recorded: in 46/73 (63%) cases swelling was noted to be reduced, in 19/73 no change was recorded and a worsening of swelling was reported in 8 cases. Diplopia improved in 13 cases and worsened in 4 (n=17). Conclusions: No statistically significant rise in intraocular pressure was observed following orbital steroid injections.