Thyroid eye disease that is a complication of Graves' disease, how will the new treatment change the back of the eye - Interpreting changes in muscle and fat using MRI -

Researcher information

overview

A research group at the Kyoto University Graduate School of Medicine, including Assistant Professor Ichiro Yamauchi, Professor Daisuke Yabe (Diabetes, Endocrinology, and Nutritional Medicine), Lecturer Manabu Miyata (Ophthalmology), and Associate Professor You Kishimoto (Otorhinolaryngology/Head and Neck Surgery), conducted a detailed analysis of the effects of teprotumumab on thyroid eye disease using MRI, and clarified the differences from conventional treatment centered on steroid pulse therapy. This result was published early on August 25, 2026 (local time) in the American international academic journal "The Journal of Clinical Endocrinology & Metabolism."

Thyroid ophthalmopathy is a typical complication of Graves' disease, and proptosis is one of the main symptoms. While there are many patients for whom conventional treatments do not sufficiently improve proptosis, teprotumumab, which was approved in Japan in 2024, has been reported to have a high improvement effect. However, there has been limited research examining this difference.

In Japan, it is recommended to use MRI to evaluate the condition, and at our hospital we have also taken MRI before and after treatment. In this study, after teprotumumab treatment, both the extraocular muscles that move the eyes and orbital fat decreased, while with conventional treatment, the extraocular muscles decreased but orbital fat increased. It has been shown that changes in orbital fat may be a contributing factor to the small improvement in proptosis with conventional treatment. Additionally, extraocular muscles that were found to be inflamed on MRI significantly shrunk after treatment, and patients with inflammation in multiple extraocular muscles showed greater improvement in proptosis with teprotumumab.

image