Changes in ocular biomechanics after treatment for active Graves’ orbitopathy

Li, H. X.; Zhao, Xinheng; Song, Yi; Mu, Bokun; Pan, Ye; Zhao, Hong; Wang, Yuan

doi:10.1007/s40618-020-01322-5

Cited by 7 publications

(17 citation statements)

References 32 publications

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“…The MAIC analyses were conducted to compare IVMP and teprotumumab with each other and placebo for change from baseline in proptosis and diplopia response in 4 steps. First, data from the teprotumumab pooled trials 7,8 were matched to the patient cohorts in the IVMP studies [12][13][14][15][16][17][18][19][20][21][22][23] based on inclusion/ exclusion criteria. Second, data were adjusted for outcomespecific prognostic factors (ie, patient characteristics that are associated with the outcomes) and treatment-effect modifiers (ie, patient characteristics that may affect the effectiveness of treatment on outcome) using inverse propensity score weighting.…”

Section: Methods For Maic Analysesmentioning

confidence: 99%

“…See eAppendix 2 and the eFigure in the Supplement for details. [12][13][14][15][16][17][18][19][20][21][22][23]…”

Section: Literature Review For Ivmp Studiesmentioning

confidence: 99%

“…2 5 No IVMP studies were placebo-controlled, 7 were RCTs, [12][13][14][15][16][17][18] and the rest were observational. [19][20][21][22][23] The teprotumumab studies were placebocontrolled, double-masked, multicenter studies conducted in Europe and the US. 7,8 Two of the IVMP studies were multicenter and the rest were single center; 5 were conducted in Europe, 1 in Turkey, and 6 in China.…”

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

“…Patient inclusion criteria were similar, and all studies included patients 18 years or older with moderate to severe active TED (ie, patients with similar levels of inflammation and with a clinical activity score ≥3). [12][13][14][15][16][17][18][19][20][21][22][23] Baseline characteristics were similar across studies: mean age ranged from 35 to 52 years; proportion of women ranged from 35% to 80%; duration of TED symptoms, if reported, was approximately 1 year or less; baseline proptosis ranged from 17 to 24 mm; and proportion of patients with baseline diplopia (any grade) ranged from 35% to 100% (Table ). [12][13][14][15][16][17][18][19][20][21][22][23] Some differences were noted for the proportion of smokers across the studies, which ranged from 22% to 76% (Table ).…”

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19][20][21][22][23] Baseline characteristics were similar across studies: mean age ranged from 35 to 52 years; proportion of women ranged from 35% to 80%; duration of TED symptoms, if reported, was approximately 1 year or less; baseline proptosis ranged from 17 to 24 mm; and proportion of patients with baseline diplopia (any grade) ranged from 35% to 100% (Table ). [12][13][14][15][16][17][18][19][20][21][22][23] Some differences were noted for the proportion of smokers across the studies, which ranged from 22% to 76% (Table ). [12][13][14][15][16][17][18][19][20][21][22][23] For the proptosis and diplopia analyses, 419 and 125 patients receiving IVMP were included, respectively.…”

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

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Proptosis and Diplopia Response With Teprotumumab and Placebo vs the Recommended Treatment Regimen With Intravenous Methylprednisolone in Moderate to Severe Thyroid Eye Disease

Douglas

Dailey

Subramanian³

et al. 2022

JAMA Ophthalmol

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IMPORTANCE Thyroid eye disease can be a debilitating autoimmune disorder characterized by progressive proptosis or diplopia. Teprotumumab has been compared with placebo in randomized clinical trials, but not with intravenous methylprednisolone (IVMP), which sometimes is used in clinical practice for this condition.OBJECTIVE To conduct a matching-adjusted indirect comparison of teprotumumab vs IVMP vs placebo.DATA SOURCES Deidentified patient-level data from teprotumumab trials and aggregate-level data from literature on the most recommended regimen of IVMP.STUDY SELECTION PubMed and Embase were searched for randomized/observational studies using key terms and controlled vocabulary. Full texts of eligible articles were reviewed and cataloged. DATA EXTRACTION AND SYNTHESISConducted by 1 reviewer (R.A.Q.) and 1 verifier (R.B.), including study characteristics, eligibility criteria, baseline characteristics, and outcomes. MAIN OUTCOMES AND MEASURESChanges in proptosis by millimeter and diplopia response (percentage with Ն1 grade reduction) from baseline to week 12 in patients receiving IVMP and placebo, and to week 24 in patients receiving teprotumumab. RESULTSThe search identified 1019 records, and 6 through manual searches, alerts, and secondary references. After excluding duplicates and screening full-text records, 12 IVMP studies were included in the matching-adjusted indirect comparison (11 for proptosis change [n = 419], 4 for diplopia response [n = 125], and 2 teprotumumab [n = 79] and placebo [n = 83] comparator studies). Treatment with IVMP resulted in a proptosis difference of −0.16 mm (95% CI, −1.55 to 1.22 mm) from baseline to week 12 vs placebo. The proptosis treatment difference between IVMP and teprotumumab of −2.31 mm (95% CI, −3.45 to −1.17 mm) favored teprotumumab. Treatment with IVMP (odds ratio, 2.69; 95% CI, 0.94-7.70) was not favored over placebo in odds of diplopia response; however, teprotumumab was favored over IVMP (odds ratio, 2.32; 95% CI, 1.07-5.03). CONCLUSIONS AND RELEVANCEThis meta-analysis suggests that use of IVMP is associated with a small, typically not clinically relevant, change from baseline in proptosis vs placebo, with modest changes in diplopia. While this nonrandomized comparison suggests that use of teprotumumab, compared with IVMP, is associated with greater improvements in proptosis and may be twice as likely to have a 1 grade or higher reduction in diplopia, randomized trials comparing these 2 treatments would be warranted to determine if 1 treatment is superior to the other to a clinically relevant degree.

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Section: Methods For Maic Analysesmentioning

confidence: 99%

“…See eAppendix 2 and the eFigure in the Supplement for details. [12][13][14][15][16][17][18][19][20][21][22][23]…”

Section: Literature Review For Ivmp Studiesmentioning

confidence: 99%

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

Section: Study Characteristics and Meta-analysesmentioning

confidence: 99%

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Proptosis and Diplopia Response With Teprotumumab and Placebo vs the Recommended Treatment Regimen With Intravenous Methylprednisolone in Moderate to Severe Thyroid Eye Disease

Douglas

Dailey

Subramanian³

et al. 2022

JAMA Ophthalmol

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Evaluation of orbital soft tissue biomechanical parameters in patients with thyroid eye disease using the non-contact Corvis ST

et al. 2023

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Effect of Intraorbital Mechanical Compression on Retinal Microvascular Perfusion in Quiescent Thyroid-Associated Ophthalmopathy Based on Ocular Biomechanics Measured by Corvis ST

Fang,

Zhou,

Qian

et al. 2024

Ophthalmol Ther

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Introduction To analyze the correlation between orbital compliance and retinal vessel density (VD) based on dynamic Scheimpflug analyzer (Corvis ST) and optical coherence tomographic angiography (OCT-A). Methods In this prospective observational study, 65 eyes of 44 patients with thyroid-associated ophthalmopathy (TAO) in quiescent stage were included (15 males and 29 females). The whole eye movement (WEM) was detected by Corvis ST. The superficial capillary plexus VD (SCP-VD) and deep capillary plexus VD (DCP-VD) were obtained by scanning the 3 × 3 mm area around the fovea using OCT-A, while the peripapillary vessel density (ppVD) was obtained by scanning the 4.5 × 4.5 mm area around the optic disk. Covariances including biomechanically corrected intraocular pressure (bIOP), axial length, age and gender were adjusted during data analysis. Results The mean WEM of the participants was 0.235 ± 0.066 mm. The mean SCP-VD and DCP-VD in whole image were 46.20% ± 3.77% and 50.51% ± 3.96%; the mean whole pp-VD was 49.75% ± 2.01%. WEM was positively correlated with SCP-VD ( r = 0.327, p = 0.01) and the whole pp-VD ( r = 0.394, p < 0.01) after adjusting by gender, axial length (AL), age and bIOP, but it was not significantly correlated with DCP-VD ( r = 0.072 p = 0.581). Conclusion Increase in orbital pressure might reduce retinal microvascular perfusion. Our data suggest orbital mechanical compression may be an important cause of retinal VD changes in quiescent patients with TAO.

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Changes in ocular biomechanics after treatment for active Graves’ orbitopathy

Cited by 7 publications

References 32 publications

Proptosis and Diplopia Response With Teprotumumab and Placebo vs the Recommended Treatment Regimen With Intravenous Methylprednisolone in Moderate to Severe Thyroid Eye Disease

Proptosis and Diplopia Response With Teprotumumab and Placebo vs the Recommended Treatment Regimen With Intravenous Methylprednisolone in Moderate to Severe Thyroid Eye Disease

Evaluation of orbital soft tissue biomechanical parameters in patients with thyroid eye disease using the non-contact Corvis ST

Effect of Intraorbital Mechanical Compression on Retinal Microvascular Perfusion in Quiescent Thyroid-Associated Ophthalmopathy Based on Ocular Biomechanics Measured by Corvis ST

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