Bilateral Retinal Nerve Fiber Layer Loss and Recovery with Teprotumumab in Thyroid Eye Disease  

作　　者：Christine Wang Abdulaziz Alsumait Nikisha Q. Richards Surbhi Bansal Christine Wang;Abdulaziz Alsumait;Nikisha Q. Richards;Surbhi Bansal(Department of Ophthalmology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA;School of Medicine, Virginia Commonwealth University Richmond, VA, USA)

机构地区：[1]Department of Ophthalmology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA [2]School of Medicine, Virginia Commonwealth University Richmond, VA, USA

出　　处：《Open Journal of Ophthalmology》2024年第3期196-203,共8页眼科学期刊（英文）

摘　　要：Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.

关 键 词：Teprotumumab Thyroid Eye Disease RNFL Clinical Activity Score Ocular Hypertension 

分 类 号：R73[医药卫生—肿瘤]