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Teprotumumab for Asymmetric Thyroid Eye Disease

      A 53-year-old woman presented with a 3-month history of markedly asymmetric thyroid eye disease with clinical activity scores (CAS) of 7 in her right eye (OD) and 1 in her left eye (OS). She had no diplopia. Exophthalmometry measured 27 mm OD and 18 mm OS (Fig A-F). Best corrected visual acuity was 20/20 in both eyes (OU). Following 8 infusions of teprotumumab over 24 weeks, exophthalmometry was 22 mm OD and 17 mm OS, CAS was 1 OU, and her appearance was more symmetrical. Teprotumumab may act differentially on the worse affected orbit and may therefore improve asymmetry (Magnified version of Fig A-F is available online at www.aaojournal.org).
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