The management of thyroid eye disease (TED) remains a therapeutic
challenge. The current established therapies are unsatisfactory in
one-third of the patients and have many limitations. Rituximab (RTX) is
a CD20+ B-cell depleting monoclonal antibody approved for the treatment
of non-Hodgkin lymphomas, chronic lymphocytic leukemia, and rheumatoid
arthritis. The early experience with RTX suggests that it is a promising
alternative therapy for TED. Rituximab may compare favorably to the
conventional glucocorticoid therapy and causes less collateral damage
than retrobulbar orbital radiation and decompression surgery. In
addition, the preliminary studies on RTX’s proposed mechanism of action
have revealed new insights into the pathogenic role of B-cells in TED.
We summarize the current literature on the clinical application of RTX
in TED and discuss its putative mechanisms of action. (Surv Ophthalmol
58:252-265, 2013. (C) 2013 Elsevier Inc. All rights reserved.
