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Ophthalmology · Neuro-ophthalmology and pupils: teprotumumab
Sample itemA 42-year-old woman with active moderate to severe thyroid eye disease has proptosis and diplopia not controlled by earlier measures. Which targeted drug can reduce proptosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Teprotumumab
Teprotumumab blocks the insulin-like growth factor-1 receptor on orbital fibroblasts and reduces proptosis and diplopia. Ranibizumab is anti-VEGF. Methimazole treats hyperthyroidism but not the orbitopathy, and radioiodine can worsen eye disease.
Option by option
A. Ranibizumab
Ranibizumab is an anti-VEGF agent not used for thyroid orbitopathy.
B. Radioiodine
Radioiodine can aggravate eye disease and is not a treatment for it.
C. Methimazole
Methimazole controls thyroid hormone levels, not the orbital inflammation.
D. Teprotumumab (correct)
Correct. Teprotumumab blocks the IGF-1 receptor in orbital fibroblasts.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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