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This Japanese real-world study demonstrates that teprotumumab significantly improves clinical manifestations of thyroid eye disease (TED), including proptosis, clinical activity, diplopia, and thyroid-stimulating antibody levels. Magnetic resonance imaging (MRI) reveals that teprotumumab reduces both extraocular muscle and orbital fat involvement, whereas intravenous glucocorticoid therapy (IVGC) reduces muscle inflammation but may increase orbital fat. Inflamed extraocular muscles identified by MRI are responsive to both therapies, underpinning their roles as critical treatment targets.
