Effects of Teprotumumab on Eyelid Retraction in Thyroid Eye Disease

Eman M Al-Sharif; Jason Zhou; Marissa K Shoji; Kaela Acuff; Catherine Y Liu; Bobby S Korn; Don O Kikkawa

doi:10.1097/IOP.0000000000002707

Effects of Teprotumumab on Eyelid Retraction in Thyroid Eye Disease

Ophthalmic Plast Reconstr Surg. 2024 May 9. doi: 10.1097/IOP.0000000000002707. Online ahead of print.

Authors

Eman M Al-Sharif^{1

2}, Jason Zhou³, Marissa K Shoji¹, Kaela Acuff¹, Catherine Y Liu¹, Bobby S Korn^{1

4}, Don O Kikkawa^{1

4}

Affiliations

¹ Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, UC San Diego Shiley Eye Institute, La Jolla, California, U.S.A.
² Surgery Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
³ University of Maryland School of Medicine, Baltimore, U.S.A.
⁴ Division of Plastic and Reconstructive Surgery, Department of Surgery, UC San Diego School of Medicine, La Jolla, California, U.S.A.

PMID: 38722772
DOI: 10.1097/IOP.0000000000002707

Abstract

Purpose: This study evaluates the efficacy of teprotumumab in reducing eyelid retraction in thyroid eye disease (TED) patients.

Methods: 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.

Results: 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].

Conclusion: 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.