Teprotumumab Treats Sight-Threatening Thyroid Eye Disease

We report a unique case of dysthyroid optic neuropathy (DON) treated primarily with teprotumumab and corticosteroids. The patient showed rapid improvement in visual acuity, visual field loss, color vision, and reduction in exophthalmos. Teprotumumab could be considered for treatment of DON Thyroid-associated orbitopathy is an autoimmune condition affecting the orbital tissues. Current therapy for dysthyroid optic neuropathy (DON) consists of corticosteroids, orbital irradiation and/or surgical decompression. Teprotumumab, an IGF-IR blocker, is a new, promising treatment option. In the phase 3 trial, patients with optic neuropathy were specifically excluded. (1) We believe this to be the first report of teprotumumab use for primary treatment of DON.