Abstract
Purpose :
Dry eye syndrome occurs in up to 85% of patients with thyroid eye disease (TED), and it is unclear how teprotumumab affects this symptomatology. We tested the hypothesis that treatment with teprotumumab would significantly reduce both subjective and objective ocular surface disease symptoms in TED patients.
Methods :
This was a retrospective cohort study of adult patients with thyroid eye disease treated at the University of California, Los Angeles since 2014. We assessed the effect of teprotumumab therapy on subjective ocular surface symptoms as measured by the Ocular Surface Disease Index (OSDI), a previously validated questionnaire for dry eye syndrome. The degree of change from baseline OSDI score was compared between patients that received teprotumab and baseline score-matched control patients that never received it. Change in objective dry eye manifestations like punctate epithelial erosions and superior limbic keratopathy were also studied. Statistical analysis was performed using an independent two-tailed t test with an alpha level of 0.05.
Results :
We identified 18 patients (14 females, 4 males) treated with teprotumumab with a mean age of 53.5 (SD=14.9), and 18 controls (15 females, 3 males) with a mean age of 49.8 (SD=13.3). The average time from baseline OSDI to the next patient visit was 5.3 months (SD=3.0). Patients treated with teprotumumab experienced a statistically significant decrease of 15.4 (SEM=3.6) in their OSDI score compared to the controls (p=0.002). The change in severity of punctate epithelial erosions or superior limbic keratoconjunctivitis did not differ between groups.
Conclusions :
Teprotumumab was effective in significantly mitigating clinical ocular surface symptoms, although the effect on objective physical exam findings was negligible. Given the complexity of dry eye syndrome and the importance of the subjective experience of disease, our findings illustrate a possible benefit of this therapy.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.