1.Advances in subretinal hyperreflective material in neovascular age-related macular degeneration
Congbi LIANG ; Changzheng CHEN
Chinese Journal of Experimental Ophthalmology 2024;42(5):487-490
Subretinal hyperreflective material (SHRM) is a morphologic feature seen on optical coherence tomography as hyperreflective material outside the retina and within the retinal pigment epithelium.SHRM is common in untreated neovascular age-related macular degeneration (nAMD) and often persists after anti-vascular endothelial growth factor therapy.It is also seen in central serous chorioretinopathy, uveitis, myopic choroidal neovascularization, myopic macular degeneration, Best disease, retinal malnutrition, Erdheim-Chester disease and so on.SHRM is closely associated with loss of the ellipsoid zone, scarring, disruption of outer limiting membrane, macular atrophy and outer retinal tubulations, and is significantly associated with visual impairment.Some SHRM was regression after anti-vascular endothelial growth factor therapy.The prognosis and responses to treatment of SHRM may vary depending on its components and characteristics.Identifying the morphologic characteristics and functional consequences of SHRM in nAMD may deepen the clinical understanding of SHRM.
2.Progress in the treatment of thyroid-associated ophthalmopathy with teprotumumab
Congbi LIANG ; Changzheng CHEN
Chinese Journal of Experimental Ophthalmology 2023;41(11):1140-1144
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disease of complex etiology and pathogenesis, which can cause a variety of ocular manifestations and even threaten vision.Glucocorticoids are often used as the first-line treatment in the clinic, but some patients become resistant to them.The insulin-like growth factor-1 receptor (IGF-1R) plays a key role in the development of TAO.Teprotumumab is an anti-IGF-1R monoclonal antibody that can specifically bind to the IGF-1R and block its binding to the α-subunit of IGF-1 to exert biological effects.Clinical trials have shown that teprotumumab has good efficacy in reducing proptosis (decrease≥2 mm) and inflammatory activity (CAS decrease≥2 points) of active moderate-to-severe TAO.Most side effects are mild or moderate.Hyperglycemia is currently an identifiable adverse event associated with teprotumumab that can be controlled with medication.Pregnancy and inflammatory bowel disease are contraindications for teprotumumab due to its teratogenicity to the fetus and its ability to severely exacerbate inflammatory bowel disease.The US FDA has officially approved teprotumumab for the treatment of active moderate-to-severe TAO in January 2020.This article reviews the progress of clinical trials on the mechanism, efficacy and safety of teprotumumab in the treatment of TAO.

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