甲状腺眼病患者接受teprotumumab治疗与未接受teprotumumab治疗的眼科手术率比较

IF 1.2 4区 医学 Q3 OPHTHALMOLOGY
Arquivos brasileiros de oftalmologia Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI:10.5935/0004-2749.2024-0319
Taylor J Linaburg, Tejus Pradeep, Brian Rinelli, Yuanyuan Chen, Yineng Chen, Gui-Shuang Ying, César A Briceño, Madhura Tamhankar
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引用次数: 0

摘要

目的:本研究评估活动性甲状腺眼病患者接受teprotumumab治疗与未接受teprotumumab治疗的患者相比,与甲状腺眼病相关的眼睑手术、斜视手术和眼窝减压的发生率。方法:在这项单中心纵向研究中,我们比较了2017年2月1日至2020年1月31日(teprotumumab前时代)评估的活动性甲状腺眼病患者与2020年2月1日至2023年4月30日(teprotumumab时代)的患者。将前teprotumumab时代接受糖皮质激素和/或眶放射治疗的患者与接受teprotumumab治疗、加或不加糖皮质激素和/或眶放射治疗的患者进行比较。主要结果是随访至少6个月的患者眼眶减压、斜视手术和眼睑手术的发生率。眼眶减压涉及两个或更多的壁被归类为严重。结果:486例患者中,106例为活动性甲状腺眼病。其中33例来自前teprotumumab时代;22例接受了皮质类固醇和/或眶放射治疗,11例未接受治疗。73例患者来自teprotumumab时代;37例接受teprotumumab治疗(合并或不合并皮质类固醇和/或眶放射),10例单独接受皮质类固醇和/或眶放射,26例未接受治疗。组间人口统计数据具有可比性。在teprotumumab治疗前,使用皮质类固醇和/或眼眶放射治疗(8只单壁,3只≥两壁)的44只眼中有11只(25.0%)进行了眼眶减压,而在teprotumumab治疗前,使用或不使用皮质类固醇和/或眼眶放射治疗(均为单壁)的74只眼中有3只(4.1%)进行了眼眶减压。在teprotumumab时代,总的眼眶减压率和≥两壁减压率显著降低(p=0.02和p=0.0496)。两组间单壁减压无显著性差异(p=0.07)。斜视手术率(27.3%比13.5%,p=0.19)和眼睑手术率(22.7%比21.6%,p=0.92)在不同时代间无显著差异。结论:在活动性甲状腺眼病患者中,与单独使用皮质类固醇和/或眶放射治疗相比,teprotumumab治疗与眶减压的发生率和严重程度显著降低相关。然而,斜视和眼睑手术的发生率在两组之间保持相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of ophthalmic surgery rates in teprotumumab-treated vs. teprotumumab-untreated thyroid eye disease patients.

Purpose: This study evaluated rates of thyroid eye disease-related eyelid surgeries, strabismus surgeries, and orbital decompressions in active thyroid eye disease patients treated with teprotumumab compared to those who were not.

Methods: In this single-center longitudinal study, we compared patients with active thyroid eye disease evaluated from 02/01/2017 to 01/31/2020 (pre-teprotumumab era) with those seen from 02/01/2020 to 04/30/2023 (teprotumumab era). Patients from the pre-teprotumumab era who received corticosteroids and/or orbital radiation were compared with those in the teprotumumab era treated with teprotumumab, with or without corticosteroids and/or orbital radiation. The primary outcomes were rates of orbital decompressions, strabismus surgery, and eyelid surgery among patients with at least 6 months of follow-up. Orbital decompressions involving two or more walls were classified as severe.

Results: Of 486 records reviewed, 106 patients had active thyroid eye disease. Among them, 33 were from the pre-teprotumumab era; 22 received corticosteroids and/or orbital radiation, and 11 received no treatment. Seventy three patients were from the teprotumumab era; 37 received teprotumumab (with or without corticosteroids and/or orbital radiation), 10 received corticosteroids and/or orbital radiation alone, and 26 received no treatment. Demographics were comparable between groups. Orbital decompression was performed in 11 of 44 eyes (25.0%) in the pre-teprotumumab era treated with corticosteroids and/or orbital radiation (8 one-wall, 3 ≥two-wall), compared to 3 of 74 eyes (4.1%) in the teprotumumab era treated with teprotumumab with or without corticosteroids and/or orbital radiation (all one-wall). The overall rate of orbital decompressions and the rate of ≥two-wall decompressions were significantly lower in the teprotumumab era (p=0.02 and p=0.0496, respectively). There was no significant difference in one-wall decompressions between era (p=0.07). Rates of strabismus surgeries (27.3% vs. 13.5%, p=0.19) and eyelid surgeries (22.7% vs. 21.6%, p=0.92) did not significantly differ between the era.

Conclusions: In patients with active thyroid eye disease, treatment with teprotumumab was associated with a significantly lower rate and severity of orbital decompressions compared to treatment with corticosteroids and/or orbital radiation alone. However, the rates of strabismus and eyelid surgeries remained similar between groups.

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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
200
审稿时长
6-12 weeks
期刊介绍: The ABO-ARQUIVOS BRASILEIROS DE OFTALMOLOGIA (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - electronic version), the official bimonthly publication of the Brazilian Council of Ophthalmology (CBO), aims to disseminate scientific studies in Ophthalmology, Visual Science and Health public, by promoting research, improvement and updating of professionals related to the field.
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