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Type presentatieE-poster
TitelImprovement of Chorioretinal Folds after Teprotumumab in Severe Graves’ Orbitopathy
DoelWe report the case of a male in his forties, non-smoker, with biochemically proven active Graves’ orbitopathy (GO), with a clinical activity score (CAS) of 5/7 in the right and 1/7 in the left eye. Despite prompt treatment with thiamazole, β-blockers, selenium supplementation and intravenous methylprednisolone according to the EUGOGO guidelines, refractory disease was noted in the right eye, with a marked increase in swelling and proptosis, and a new finding of “curtain”-like, resulting in new onset metamorphopsia and visual loss. It is postulated that a combination of inflammation and choroidal venous congestion causes folding over Bruch’s membrane. Chorioretinal folds are a rare complication of GO, with only a handful of reported cases.
MethodesBecause the patient preferred a deferral of orbital decompression, teprotumumab (TEPEZZA®), a novel insulin-like growth factor I receptor (IGF-IR) inhibitor, was initiated as second line treatment with four injections spaced three weeks apart.
ResultatenPreliminary results showed marked improvement in proptosis, CAS, metamorphopsia and vision with regression of chorioretinal folds. Therapy is well tolerated, with only mild hyperglycemia on the day of injection as a side effect. No hearing impairment was reported during treatment.
ConclusieThis case highlights the efficacy and excellent tolerance of teprotumumab (TEPEZZA®) in treating a severe GO presenting with a rare complication of chorioretinal folds.
BelangenverstrengelingNee
Auteurs 1
NaamJOOS
InitialenB
InstituutUniversitair Ziekenhuis Gent
StadGent
Auteurs 2
NaamVan Haecke
InitialenH
InstituutGoes Oogcentrum
StadAntwerp
Auteurs 3
NaamVan den Bruel
InitialenA
InstituutAZ Sint-Jan
StadBrugge
Auteurs 4
NaamVandelanotte
InitialenS
InstituutAZ Sint-Jan
StadBrugge
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