Al-Sharif Eman M, Zhou Jason, Shoji Marissa K, Acuff Kaela, Liu Catherine Y, Korn Bobby S, Kikkawa Don O
Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, UC San Diego Shiley Eye Institute, La Jolla, California, U.S.A.
Surgery Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Ophthalmic Plast Reconstr Surg. 2025;41(1):22-27. doi: 10.1097/IOP.0000000000002707. Epub 2024 May 9.
This study evaluates the efficacy of teprotumumab in reducing eyelid retraction in thyroid eye disease (TED) patients.
This retrospective study included patients with active or chronic moderate-to-severe TED who completed at least 4 cycles of teprotumumab. Patients with upper and/or lower eyelid retraction, defined as margin-to-reflex distance (MRD) 1 and/or MRD2 of more than 5 mm, in one or OU were included. The main outcome measure was a change in MRD1 and MRD2 after treatment. Changes in MRD1 and MRD2 were each analyzed for correlation (r) with changes in exophthalmolmetry. Student t test was performed for each comparison, and p values <0.05 were considered significant.
The study included 91 patients, predominantly female (87%), with an average age of 52.02 ± 14.6 years. The mean baseline proptosis measurement was 21.8 ± 2.9 OD and 21.7 ± 3.3 OS. The average MRD1 was 5.5 ± 1.5 OD and 5.4 ± 1.7 OS, and the average MRD2 was 6.1 ± 1.1 OD and 6.2 ± 1.1 OS. The follow-up duration post-treatment was 37.5 ± 31.7 weeks. At first follow-up post-treatment, the mean change in proptosis, MRD1, and MRD2 were -2.6 ± 2.0 OD, -2.5 ± 2.1 OS, -0.8.5 ± 1.4 OD, -0.8 ± 1.0 OS, and -0.7 ± 0.9 OD, -0.8 ± 1.0 OS, respectively. Correlation analysis showed that proptosis reduction was positively correlated with MRD1 and MRD2 reduction at the first post-treatment follow-up (MRD1: r = 0.23, p value < 0.01; MRD2: r = 0.17, p = 0.03].
Teprotumumab treatment improves upper and lower eyelid retraction. The improvement in MRD correlated positively with proptosis reduction, indicating the influence of globe position on eyelid position.
本研究评估替普罗单抗在减轻甲状腺眼病（TED）患者眼睑退缩方面的疗效。
这项回顾性研究纳入了患有活动性或慢性中重度TED且完成至少4个周期替普罗单抗治疗的患者。纳入一只眼或双眼存在上睑和/或下睑退缩的患者，上睑和/或下睑退缩定义为缘到反射距离（MRD）1和/或MRD2超过5毫米。主要结局指标是治疗后MRD1和MRD2的变化。分别分析MRD1和MRD2的变化与眼球突出度变化的相关性（r）。每次比较均进行Student t检验，p值<0.05被认为具有统计学意义。
该研究纳入了91例患者，主要为女性（87%），平均年龄为52.02±14.6岁。平均基线眼球突出度测量值右眼为21.8±2.9，左眼为21.7±3.3。平均MRD1右眼为5.5±1.5，左眼为5.4±1.7，平均MRD2右眼为6.1±1.1，左眼为6.2±1.1。治疗后的随访时间为37.5±31.7周。在治疗后的首次随访时，眼球突出度、MRD1和MRD2的平均变化分别为右眼-2.6±2.0，左眼-2.5±2.1；右眼-0.85±1.4，左眼-0.8±1.0；右眼-0.7±0.9，左眼-0.8±1.0。相关性分析显示，在治疗后的首次随访中，眼球突出度降低与MRD1和MRD2降低呈正相关（MRD1：r = 0.23，p值<0.01；MRD2：r = 0.17，p = 0.03）。
替普罗单抗治疗可改善上睑和下睑退缩。MRD的改善与眼球突出度降低呈正相关，表明眼球位置对眼睑位置有影响。
