Teprotumumab for the treatment of mild compressive optic neuropathy in thyroid eye disease: A report of two cases

Carolina A Chiou; Edith R Reshef; Suzanne K Freitag

doi:10.1016/j.ajoc.2021.101075

Teprotumumab for the treatment of mild compressive optic neuropathy in thyroid eye disease: A report of two cases

Am J Ophthalmol Case Rep. 2021 Mar 17:22:101075. doi: 10.1016/j.ajoc.2021.101075. eCollection 2021 Jun.

Authors

Carolina A Chiou¹, Edith R Reshef¹, Suzanne K Freitag¹

Affiliation

¹ Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Abstract

Purpose: To report two cases of thyroid eye disease (TED) associated compressive optic neuropathy (CON) that resolved after treatment with teprotumumab.

Observation: Two patients presented with active TED resulting in mild CON with the typical corresponding visual field (VF) defects. Both patients were initiated on intravenous (IV) corticosteroid therapy but despite treatment had persistent VF defects. Both patients were then treated with teprotumumab and demonstrated marked clinical improvement and complete resolution of TED-CON VF defects early in their infusion course.

Conclusions and importance: These cases suggest that teprotumumab can be a rapid and effective treatment for TED-CON, and raises the question of whether it may be superior to IV corticosteroid therapy.

Keywords: Compressive optic neuropathy; Graves' disease; Teprotumumab; Thyroid eye disease; Visual field defect.

Publication types

Case Reports