Orbital lymphocyte populations in three states of thyroid eye disease

We report histopathologic orbital tissue analysis from three patients with thyroid eye disease (TED) – active, chronic, and post-teprotumumab to better characterize orbital cellular populations in these varying states of TED. Orbital tissues in TED demonstrate minimal lymphocytic infiltration in fat and Mueller's muscle. Following teprotumumab treatment, the tissues were devoid of lymphocytes with only perivascular cuffs of T-lymphocytes remaining in orbital fat. In active TED, post-teprotumumab treatment, and in quiescent TED, orbital fat may not show significant inflammatory infiltration. More work is warranted to characterize specific cellular effects of teprotumumab and other biologics.