Sears Connie M, Azad Amee D, Dosiou Chrysoula, Kossler Andrea L
Department of Ophthalmology, Byers Eye Institute.
Department of Medicine-Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine, Palo Alto, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2021;37(3S):S157-S160. doi: 10.1097/IOP.0000000000001831.
A 45-year-old male presented with active progressive thyroid eye disease refractory to intravenous steroids and right orbital radiation. Visual acuity, left relative afferent pupillary defect, and Humphrey visual field defects were consistent with worsening left dysthyroid optic neuropathy. Orbital MRI demonstrated extraocular muscle enlargement and effacement of the left optic nerve sheath. After 2 infusions of teprotumumab, the patient's visual acuity, relative afferent pupillary defect, Humphrey visual fields, proptosis, and extraocular muscle size improved. This is the first report of dysthyroid optic neuropathy responsive to teprotumumab, and it supports the need for further studies to better understand the role of teprotumumab in treating sight-threatening thyroid eye disease.
一名45岁男性患有活动性进行性甲状腺眼病，对静脉注射类固醇和右眼眶放疗均无反应。视力、左侧相对传入性瞳孔障碍和汉弗莱视野缺损与左侧甲状腺功能障碍性视神经病变恶化一致。眼眶磁共振成像显示眼外肌增大和左侧视神经鞘膜受压。在输注两次替普罗单抗后，患者的视力、相对传入性瞳孔障碍、汉弗莱视野、眼球突出和眼外肌大小均有改善。这是关于替普罗单抗治疗甲状腺功能障碍性视神经病变有效的首例报告，它支持开展进一步研究以更好地了解替普罗单抗在治疗威胁视力的甲状腺眼病中的作用。
