Purchase this article with an account.
H.G. Saadati, R. Diba, M.A. Ahmadi, T. Shepler, M. Talpaz, H. Kantarjian, B. Esmaeli; Management of Periorbital Edema and Epiphora: Common Ocular Side Effects of Imatinib Mesylate (Gleevec) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4695.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report periorbital edema and epiphora as side effects associated with imatinib mesylate (Gleevec). Methods:Between January and December 2002, we examined 12 patients treated with Gleevec at our institution and had epiphora as their primary ocular complaint. All patients underwent an ophthalmologic examination, including probing and irrigation of the nasolacrimal ducts. Results: All 12 patients had periorbital edema in addition to their primary complaint of epiphora. The mean (+ standard deviation) daily dose of Gleevec was 540 + 187mg. Three patients had conjunctival chemosis, 3 additional patients had conjunctivochalasis partially blocking the lower puncta. Probing and irrigation did not reveal punctal or canalicular stenosis or nasolacrimal duct blockage in any of the 12 patients. One patient, who had severe periorbital edema obstructing visual function, required surgical removal of large festoons in the lower eyelids. 3 patients with mild to moderate periorbital edema were treated with furosemide 40 mg daily and topical steroids and reported improvement in their epiphora. The other 8 patients were observed as their symptoms were not severe. Conclusions:Epiphora in patients receiving Gleevec is most likely due to lacrimal pump dysfunction, chemosis, and periorbital edema rather than lacrimal drainage obstruction. The use of oral diuretics and topical steroids may improve periorbital edema and epiphora. Rarely in severe cases of periorbital edema, surgical excision of periocular soft tissues may be necessary to improve function.
This PDF is available to Subscribers Only