The body of clinical evidence with teprotumumab includes top-line positive results from the Phase 3 confirmatory clinical trial, called OPTIC (Treatment of Graves' Orbitopathy (Thyroid Eye Disease) to Reduce Proptosis
with Teprotumumab Infusions in a Randomized, Placebo-Controlled, Clinical Study), presented at the 2019 American Association of Clinical Endocrinologists (AACE) meeting, as well as positive Phase 2 results.
The OPTIC study found that significantly more patients treated with teprotumumab had a meaningful improvement in proptosis
, or bulging of the eye, as compared with placebo.
The primary complain at the time of presentation was recorded as leukocoria in 13 eyes (68.4%), proptosis
in 4 eyes (21.1%), decreased vision in 1 eye (5.3%) and buphthalmos in 1 eye (5.3%).
The study met its primary endpoint, indicating more patients treated with teprotumumab compared with placebo had a meaningful improvement in proptosis
, or bulging of the eye, 82.9% of teprotumumab patients compared to 9.5% of placebo patients achieved the primary endpoint of a two mm or more reduction in proptosis
Due to the inflammation, orbital signs and symptoms, such as pain, proptosis
, ptosis, periorbital pain, diplopia, ophthalmoplegia, conjunctival hyperemia or ocular injection can be seen (8).
After getting a detailed history, main findings on her clinical examination were mild proptosis
in left eye, associated with slight chemosis, divergent squint 45 degrees and restricted extraocular movements (Elevation, depression and adduction).
Laceration of the eyeball, retrobulbar hematoma, proptosis
and damage to the optic nerve with visual impairment can occur.
On performing an examination, he had proptosis
, periorbital puffiness, dilated episcleral vessels, sluggish pupillary reflex, external ophthalmoplegia, and diminished vision.
Out of 21 cases of orbital abscess with proptosis
all showed complete resolution except two, in which CT scan was repeated and revision surgery was done.
Craniosynostosis, dolichostenomelia, proptosis
, low-set ears, arachnodactyly, camptodactyly, pes planus, pectus excavatum or carinatum, scoliosis, joint hyperextensibility or contractures, hydrocephalus, dilatation of lateral ventricles, Chiari 1 malformation may be seen in this syndrome.
Children with posterior fossa tumours can present with a persistent head tilt and proptosis
. Thyroid eye disease is the most common cause of proptosis
, and proptosis
is rarely a result of a brain tumour; however, it can occur with large lesions with or without limited eye movements.
(2,4) IOI's characteristic symptoms are pain, swelling, and proptosis
. Only 10% to 20% of patients with IOI experience decreased vision, and complete vision loss is exceptionally rare.