Drug-induced corneal epithelial changes

Area of Science:

• Ophthalmology
• Pharmacology
• Cell Biology

Background:

• Numerous pharmacologic agents can induce epithelial changes in the cornea.
• Cationic amphiphilic drugs, common in many classes, possess structures facilitating cell membrane penetration and intracellular phospholipid accumulation.
• This accumulation can manifest as specific corneal opacities, such as vortex keratopathy or diffuse haze.

Purpose of the Study:

• To review the diverse range of drugs causing corneal epithelial changes.
• To elucidate the various mechanisms underlying drug-induced corneal deposits.
• To provide insights into managing patients with these ocular side effects.

Main Methods:

• Literature review of pharmacologic agents and their ocular side effects.
• Analysis of drug structures and their correlation with corneal epithelial deposition.
• Examination of clinical presentations and visual outcomes associated with drug-induced corneal changes.

Main Results:

• Cationic amphiphilic drugs often cause vortex keratopathy with minimal visual impact.
• Antineoplastic agents may induce a diffuse corneal haze, potentially leading to dose-limiting visual disturbances.
• Other drugs can result in crystalline epithelial precipitation requiring intervention.

Conclusions:

• Understanding the mechanisms of drug-induced corneal deposits is crucial for effective patient management.
• In most cases, therapeutic drug levels can be maintained, but visual impairment necessitates physician collaboration for dose optimization.
• Close monitoring is essential, especially when drugs are linked to other ocular toxicities like optic neuropathy or retinopathy.