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Published on: July 6, 2015
Erlotinib-related keratopathy in a patient underwent laser in situ keratomileusis
Hui-Chuan Kau1, Chieh-Chih Tsai2
1a Department of Ophthalmology , Koo Foundation Sun Yat-Sen Cancer Center , Taipei , Taiwan and.
Abstract:
Erlotinib is a tyrosine kinase inhibitor of the epidermal growth factor receptor. Since there is a wide expression of the epidermal growth factor receptors in the epithelial tissues of ocular surface and adnexa, ocular adverse reactions may happen during systemic administration of erlotinib. Previously reported ocular adverse reactions of erlotinib include trichomegaly, periorbital rash, ectropion, blepharitis, persistent corneal epithelial defect, corneal ulcer and perforation. We report the first case of erlotinib-related keratopathy in a patient who had received laser in situ keratomileusis. The patient presented a special picture of flap striae related to erlotinib. Improvement of keratopathy after cessation of erlotinib was demonstrated.
Insights
Erlotinib can cause serious eye problems, including a rare condition called keratopathy, especially after laser eye surgery. Stopping the drug may improve these ocular adverse reactions.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor, is used in cancer treatment.
- Epidermal growth factor receptors are widely expressed in ocular surface and adnexal tissues.
- Systemic erlotinib administration can lead to various ocular adverse reactions.
Observation:
- This report details the first case of erlotinib-related keratopathy in a patient previously treated with laser in situ keratomileusis (LASIK).
- The patient exhibited unique flap striae, a specific ocular manifestation linked to erlotinib use.
- Ocular adverse events previously associated with erlotinib include trichomegaly, periorbital rash, ectropion, blepharitis, persistent corneal epithelial defects, corneal ulcers, and perforation.
Findings:
- Erlotinib-induced keratopathy is a newly identified ocular adverse reaction.
- The specific presentation of flap striae in the observed case is noteworthy.
- Cessation of erlotinib treatment led to the improvement of the patient's keratopathy.
Implications:
- Ophthalmologists should be aware of potential erlotinib-related keratopathy, particularly in post-LASIK patients.
- Early recognition and discontinuation of erlotinib may be crucial for managing this adverse effect.
- Further research is warranted to understand the mechanisms and prevalence of erlotinib-induced ocular toxicity.
