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Anne Kunkler, Kari Kendra, Colleen M Cebulla; Ocular side effects of novel and traditional chemotherapeutic agents. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5166.
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© ARVO (1962-2015); The Authors (2016-present)
Traditional and novel chemotherapeutics improve the prognosis and quality of life for a variety of malignancies. However, limited data are available regarding the ocular side effects of many of these novel agents. This retrospective, observational study aims to examine the ocular side effects of chemotherapeutic agents in patients treated for their malignancy at The Ohio State University.
Approval was obtained from the institutional review board at the Ohio State University. An ICD-9 search of the electronic medical record was performed for patients treated with high risk medications who were seen in the department of ophthalmology between 1/1/2010 and 2/2/2015. This search yielded 3,531 cases. The first 2,000 charts were reported previously (ARVO 2016). The last 1,531 charts were analyzed herein. A temporal association between chemotherapeutic use and development of the side effect was deemed necessary for inclusion.
Eight of the 1500 patients analyzed were oncologic patients who developed ocular side effects. The patients were being treated with Veliparib, ARRY-438162, Pimasertib/SAR245409, Ibrutinib, Ipilimumab, Paclitaxel, and Pemetrexed. The most common presenting symptoms were anterior segment side effects (red eye, dry eye, epiphora, and/or eyelid edema (4/8 or 50%)). The most common medication with anterior side effects was Ibrutinib (2/8 patients), which also induced photophobia and headache. Posterior ocular side effects were noted in a patient treated with a MEK inhibitor (ARRY-438162) who developed subretinal fluid and a patient treated with Ipilimumab developed bilateral macular edema. Pemetrexed, an antimetabolite, was associated with development of a visual field defect and suspected ischemic optic neuropathy. Every patient remained on treatment; 4 patients had resolution without changing the drug, 1 experienced complete resolution after decreasing the dose, and 3 continued to have ocular effects while on drug.
The ocular side effects found in this review were generally mild to moderate, with most either resolving while remaining on treatment or at a reduced dose.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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