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Abstract：
BACKGROUND: Entropion and secondary trichiasis can lead to irritative symptoms and essential damage of ocular surface. There is no literature reporting the lower eyelid entropion related to thyroid-associated ophthalmopathy (TAO), let alone the treatment. Treatment based on etiology may yield effective and sustained results. We report 3 case reports of lower eyelid entropion associated with TAO, and provide an effective and persistent alternative to cure this entropion via the administration of shallow periorbital injections of triamcinolone acetonide (TA).
METHODS: Three patients presented irritative symptoms of ocular surface and diplopia.
METHODS: According to thyroid dysfunction, physical examination, and imaging findings of extraocular muscle involvement, TAO and unilateral or bilateral lower eyelid entropion were diagnosed.
METHODS: We administered shallow periorbital injections of TA to the affected eye at 3- to 4-week intervals depending on clinical response.
RESULTS: All patients underwent complete correction of the lower eyelid entropion and no recurrence was found.
CONCLUSIONS: The cause of lower eyelid entropion related to TAO might be the immunoinflammatory reaction of the lower eyelid retractors, enhancing the traction of pulling the lower eyelid inferoposteriorly. This condition can be treated with shallow periorbital injections of TA. Histopathological evidence and randomized controlled trials are expected to confirm our hypothesis.
METHODS: Three patients presented irritative symptoms of ocular surface and diplopia.
METHODS: According to thyroid dysfunction, physical examination, and imaging findings of extraocular muscle involvement, TAO and unilateral or bilateral lower eyelid entropion were diagnosed.
METHODS: We administered shallow periorbital injections of TA to the affected eye at 3- to 4-week intervals depending on clinical response.
RESULTS: All patients underwent complete correction of the lower eyelid entropion and no recurrence was found.
CONCLUSIONS: The cause of lower eyelid entropion related to TAO might be the immunoinflammatory reaction of the lower eyelid retractors, enhancing the traction of pulling the lower eyelid inferoposteriorly. This condition can be treated with shallow periorbital injections of TA. Histopathological evidence and randomized controlled trials are expected to confirm our hypothesis.
摘要：
背景：内翻和继发性倒车灯可导致刺激性症状和眼表的实质性损害。没有文献报道与甲状腺相关眼病（TAO）相关的下睑内翻，更不用说治疗了。基于病因的治疗可以产生有效和持续的结果。我们报告了3例与TAO相关的下眼睑内翻病例报告，并通过浅眶周注射曲安奈德（TA）提供了一种有效且持久的替代治疗方法来治愈这种内翻。
方法：3例患者出现眼表刺激症状和复视。
方法：根据甲状腺功能异常，体检,和眼外肌受累的影像学发现，诊断为TAO和单侧或双侧下眼睑内翻。
方法：我们根据临床反应以3至4周的间隔对患眼进行浅眶周注射TA。
结果：所有患者均接受下睑内翻完全矫正，未发现复发。
结论：与TAO有关的下睑内翻的原因可能是下睑牵开器的免疫炎症反应。增强后下牵拉下眼睑的牵引力。这种情况可以通过浅眶周注射TA来治疗。组织病理学证据和随机对照试验有望证实我们的假设。
方法：3例患者出现眼表刺激症状和复视。
方法：根据甲状腺功能异常，体检,和眼外肌受累的影像学发现，诊断为TAO和单侧或双侧下眼睑内翻。
方法：我们根据临床反应以3至4周的间隔对患眼进行浅眶周注射TA。
结果：所有患者均接受下睑内翻完全矫正，未发现复发。
结论：与TAO有关的下睑内翻的原因可能是下睑牵开器的免疫炎症反应。增强后下牵拉下眼睑的牵引力。这种情况可以通过浅眶周注射TA来治疗。组织病理学证据和随机对照试验有望证实我们的假设。
