How does teprotumumab impact on ocular misalignment in thyroid eye disease?
Reviewed by Lauren Hepworth

A retrospective case review was conducted with the aim of exploring the effect of teprotumumab on objective diplopia. Adults diagnosed with thyroid eye disease, presenting with diplopia and receiving a standard six-month treatment with teprotumumab at a single centre were identified. The following data was extracted from medical records; demographics, diagnosis and course of thyroid eye disease, smoking, clinical assessment. The cases were divided into three groups: worse, stable or improved. A total of 17 cases were identified, the majority were female (n=15) with a mean age of 64 years. The majority were classified as stable (n=10), four improved and three deteriorated. The individual data extracted per case is presented. A difference identified between the groups was that vertical misalignment was significantly less in the group that deteriorated than the group that improved. The authors acknowledge study limitations including small sample size, the retrospective methodology and a limited follow-up period. This study demonstrates that teprotumumab does not eliminate ocular misalignment – information which may help with counselling patients of expectations. Future research should include longer follow-up to assess if the improvements are sustained.

Objective diplopia outcomes for patients treated with teprotumumab.
Mudakegundi S, Huang P, Henderson AD, Carey AR.
JOURNAL OF NEURO-OPHTHALMOLOGY
2024;44:80–6.