Non-surgical treatment for eyelid retraction in thyroid eye disease (TED)

2017 ◽  
Vol 102 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Ana Beatriz Diniz Grisolia ◽  
Ricardo Christopher Couso ◽  
Suzana Matayoshi ◽  
Raymond S Douglas ◽  
César Augusto Briceño
Keyword(s):  
Surgical Treatment ◽  
Botulinum Toxin Type A ◽  
Active Phase ◽  
Botulinum Toxin Type ◽  
Thyroid Eye Disease ◽  
Treatment Modalities ◽  
Eye Disease ◽  
Eyelid Retraction ◽  
Ocular Exposure ◽  
Non Surgical Treatment

Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal.

scholarly journals Migraine Headache : An Overview

2010 ◽  
Vol 23 (1) ◽  
pp. 114-119
Author(s):  
ASM Hasan ◽  
Iftekhar Mahmood ◽  
MR Islam ◽  
MSI Khan ◽  
SM Ali ◽  
...  
Keyword(s):  
Migraine Headache ◽  
Botulinum Toxin Type A ◽  
Antihypertensive Agents ◽  
Opioid Analgesics ◽  
The Elderly ◽  
Botulinum Toxin Type ◽  
The United States ◽  
Treatment Modalities ◽  
Migraine Treatment ◽  
History Of

The history of headache can be traced almost to the beginning of the history of humankind. Among the many causes of it, migraine headache is a debilitating disorder affecting millions of people in the United States and worldwide. The diagnosis of migraine can significantly affect quality of life, health care costs and daily productivity. Hundreds of trials and many guidelines have documented various approaches to migraine management, whether via acute treatment or chronic migraine prophylaxis. Acute or abortive migraine management encompasses specific and nonspecific migraine therapeutics including non-opioid and opioid analgesics, triptans and ergotamines. Prophylactic migraine management data span the pharmacological spectrum from antiepileptic and antihypertensive agents to botulinum toxin type A. Special considerations for migraine management also must be applied in various populations including children, pregnant women and the elderly. Although hundreds of clinical trials are available regarding migraine treatment modalities, this review serves as an introduction to current accepted therapeutics for migraine treatment and an overview of pharmacological prophylaxis in the modern management of migraine. TAJ 2010; 23(1): 114-119

Course of upper eyelid retraction in thyroid eye disease

2019 ◽  
Vol 104 (2) ◽  
pp. 254-259
Author(s):  
Dong Cheol Lee ◽  
Stephanie M Young ◽  
Yoon-Duck Kim ◽  
Kyung In Woo
Keyword(s):  
Positive Family History ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Clinical Activity ◽  
Eyelid Retraction ◽  
Tertiary Institution ◽  
Upper Eyelid ◽  
Upper Eyelid Retraction ◽  
History Of

AimsTo evaluate the natural course of upper eyelid retraction (UER) in patients with thyroid eye disease (TED) and factors affecting its course.MethodsRetrospective non-interventional cohort study in a single tertiary institution from March 2006 to March 2015 on patients with TED with (1) unilateral or bilateral UER within 6 months from initial presentation, and (2) no prior interventions nor surgical treatment for their UER. Main outcomes and measures were mean margin reflex distance 1 (MRD1) and factors associated with UER improvement.ResultsThere were a total of 61 patients and 81 eyes (41 unilateral and 20 bilateral UER). Mean age was 42.3±15.1 years. Mean MRD1 decreased from 6.1 mm at presentation to 4.8 mm at 12 months, and 4.4 mm at 24 months. The proportion of eyes with normalisation of lid height increased from 0% at presentation to 22.2% at 6 months, 37.0% at 12 months and 49.4% at 24 months. Mean time to normalisation of MRD1 was 18.0±12.4 months. A positive family history of TED was found to be associated with a 6.2 times lower likelihood of normalisation. Change in exophthalmometry, clinical activity score and thyroid-stimulating immunoglobulin were significantly correlated to change in MRD1 (p<0.05). There was no correlation between change in MRD1 and thyroid-stimulating hormone receptor antibodies.ConclusionAn improved knowledge of the natural history of UER in TED will allow us to better decide and evaluate the optimal management for such patients.

Surgical Treatment of Thyroid Eye Disease

Thyroid ◽  
1998 ◽  
Vol 8 (5) ◽  
pp. 447-452 ◽  
Author(s):  
LEIF TALLSTEDT
Keyword(s):  
Surgical Treatment ◽  
Thyroid Eye Disease ◽  
Eye Disease

scholarly journals Evidence-based treatment of osteoporotic vertebral compression fracture

2021 ◽  
Vol 64 (3) ◽  
pp. 200-207
Author(s):  
Subum Lee ◽  
Dae-Chul Cho ◽  
Kyong-Tae Kim ◽  
Young-Seok Lee
Keyword(s):  
Surgical Treatment ◽  
Outcome Measurement ◽  
Treatment Guideline ◽  
Treatment Modalities ◽  
Vertebral Compression Fractures ◽  
Controlled Trials ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Significant Difference ◽  
Non Surgical Treatment

The prevalence and medical costs of osteoporotic vertebral compression fractures (OVCFs) are on the rise. However, a concrete evidence-based treatment guideline has not yet been established. Despite that numerous randomized controlled trials (RCTs) were performed, the study design and outcome measurement were heterogeneous, and the results were not unified. The purpose of this review is to compare the results of high level-evidence studies to provide a background for evidence-based OVCF treatment. Many reports showed that vertebroplasty has better clinical outcomes than non-surgical treatment for OVCF, but the results of three double-blinded RCTs with the highest level of evidence did not show a significant difference between vertebroplasty and sham procedure. Whether undergoing surgical or non-surgical treatment, OVCF patient management should be started by managing osteoporosis first. Meanwhile, in the results of RCTs related to the comparison of conservative treatment modalities, the benefit of braces and a specific analgesic prescription protocol was also unclear. The presented results of each clinical trial were generally inconsistent and may not be appropriate in all situations. Any decision by clinicians to apply this evidence must be made considering individual patients and available resources. At present, controversy remains about the best treatment modality for OVCF. Large, multicenter, placebo/sham-controlled trials are needed to address this gap and establish strong evidence-based guidelines.

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