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Bilateral Retinal Nerve Fiber Layer Loss and Recovery with Teprotumumab in thyroid eye disease

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Open Journal of Ophthalmology 2024年第3期14卷 196-203页

作者： 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

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

Evaluation of macular choroidal and microvascular network changes by activity scores and serum antibodies in thyroid eye patients and healthy subjects

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International Journal of Ophthalmology(English edition) 2023年第12期16卷 2089-2094页

作者： Mehmet Erkan Dogan Ibrahim Basol Hatice Deniz Ilhan Yusuf Ayaz Olgar Ocal Department of Ophthalmology Akdeniz UniversityKonyaalti 07070AntalyaTurkey Department of Ophthalmology Kepez State HospitalAntalya 07320Turkey Department of Ophthalmology Suruc State HospitalSanliurfa 63800Turkey

AIM:To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease(TED)patients at different stages and the relationship of those changes with risk factors,serum antibodies and the severity of ***:A total of 85 participants were *** participants underwent ophthalmology and endocrinology *** choroidal thickness(SFCT),superficial(s)and deep(d)foveal avascular zone(FAZ)area,mean(m)and central(c)superficial vascular density(SVD),deep vascular density(DVD)measurements of the enrolled cases were performed with Topcon swept source optical coherence tomography(OCT)/OCT angiography(OCTA)DRI OCT *** linear regression analysis was used to explore the associations between SFCT,FAZ area,SVD,DVD and the relevant factors of ***:Those with active TED patients had higher c-DVD and m-DVD levels(Pthyroid stimulating hormone-receptor autoantibodies(TRAB)level,whereas SFCT thickened in patients with high levels of both TRAB and human thyroglobulin(hTG).There was no significant difference in SFCT,FAZ,SVD and DVD measurement at gender,between hyperthyroid and euthyroid patients and among those with or without thyroid papillary ***:The results show that both disease activation and serum antibodies differentially affect both superficial and deep retinal vascular *** has also been shown that high serum antibody levels affect choroidal thickness independent of clinical activity.

关键词： thyroid eye disease optic coherence tomography angiography vascular density choroidal thickness foveal avascular zone area

Ocular Manifestations in thyroid eye Disorder: A Cross-Sectional Study from Nepal

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International Journal of Clinical Medicine 2016年第12期7卷 814-823页

作者： Palikhe Sabita Thakur Ajit Shah Dev Narayan Sharma Ananda Kumar Acharya Niranjan Drishti eye Hospital Birtamode Nepal BP Koirala Institute of Ophthalmic Studies Institute of Medicine Tribhuvan University Kirtipur Nepal

Background: thyroid eye disease represents an organ-specific autoimmune process that is usually associated with thyroid disease. Graves’ disease is the most common thyroid abnormality associated with thyroid eye disease. Aim: This study was conducted for the profile of ocular manifestation in thyroid eye disease (TED). Methodology: A cross-sectional study of 117 cases of thyroid dysfunction was carried out at BP Koirala Institute of Health System, out of which 84 (71.79%) cases had ocular manifestation. They were evaluated and analyzed in detail and the characteristics documented included patient’s demography, ocular and systemic history and as well as ocular examination and some of the systemic and laboratory findings. Results: In this study, mean age of presentation of TED was 39.7 years. 59 patients were female and 25 were male. The maximum patients of both sexes were in the fourth decade of their lives. The common lid signs were lid retraction and lid lag. Proptosis was seen in 33.3% of cases out of which 68% had bilateral proptosis. Corneal ulcer was seen in 7.1% and optic neuropathy in 1.2% of cases. In 27.3% of cases there was elevation of IOP. Dry eye was seen in 61.9% of cases and POAG seen in 8.3% of cases. In the study population 75% were hyperthyroiditic, 16.7% were hypothyroiditic and 8.3% were in euthyroid state. Conclusion: Female was more commonly affected. The maximum number of patients of both sexes was in the fourth decade of their lives. Hyperthyroidism patient had greater chance of ocular manifestation.

关键词： thyroid eye disease Ocular Manifestation Nepal

Epstein-Barr virus-encoded small RNAs in idiopathic orbital inflammatory pseudotumor tissues: a comparative case series

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International Journal of Ophthalmology(English edition) 2017年第8期10卷 1268-1272页

作者： Min-Wei Ren Yi Du Shan Ren Cheng-Ye Tang Jian-Feng He Department of Ophthalmology the First Affiliated Hospital of Guangxi Medical University Department of Ophthalmology Liuzhou People's Hospital

AIM： To investigate the positive rate and types of cells that express Epstein-Barr virus-encoded small RNAs （EBERs） and to determine the distribution of EBER-expressing cells in idiopathic orbital inflammatory pseudotumor （IOIP） tissues. METHODS： We retrospectively examined 40 archived paraffin specimens from two teaching hospitals in Southern China between January 2007 and January 2015 that were pathologically determined to exhibit IOIP. Eleven concurrent paraffin specimens of thyroid-associated ophthalmopathy （TAO） composed the control group. In situ hybridization was performed to detect EBERs. Immunohistochemistry was employed to detect CD3, CD20, Vimentin, and smooth muscle actin （SMA）, and the positive rate, types of positive cells, and distribution and location of EBERs were evaluated. RESULTS： The positive expression rate of EBERs was 47.5% （19/40） in the IOIP group, which was significantly higher than that in the TAO group [0 （0/11）, P=-0.011]. in the IOIP group, the lymphocyte infiltrative subtype, fibrotic subtype, and mixed subtype exhibited EBER-positive rates of 57.1% （12121）, 12.5% （118）, and 54.5% （6/11）, respectively, and no significant differences were found between these subtypes （P=0.085）. Positive signals of EBERs were mainly present in medium-small lymphocytes between or around follicles and in the nuclei of activated immunoblasts （14/19）. CONCLUSION： The positive rate, types, and distribution of EBER-expressing cells in IOIP have been *** findings are conducive for a better understanding of the underlying mechanisms of Epstein-Barr virus infection in IOIP pathogenesis.

关键词： Epstein-Barr virus Epstein-Barr virus-encoded small RNAs thyroid eye disease Graves' ophthalmopathy idiopathic orbital inflammatory disease