Ocular Toxicity of Mirvetuximab

To report the clinical features and outcomes of corneal toxicity following mirvetuximab soravtansine therapy.

Five patients who were treated with mirvetuximab soravtansine were evaluated in our hospital for ocular symptoms during a period of 5 months between December 2017 and April 2018. A complete ophthalmologic examination, including anterior segment infrared reflectance (AS-IR) and anterior segment optical coherence tomography (AS-OCT), was performed.

All 5 patients were female (average age, 62.4 ± 5.5 years) and being treated for advanced epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer. Both eyes were involved in each case. Patients complained of blurred vision (n = 5), ocular pain (n = 2), tearing (n = 5), foreign-body sensation (n = 4), and photophobia (n = 4). Slit-lamp examination demonstrated fine corneal subepithelial opacities, mainly involving the corneal periphery migrating toward the center. AS-IR revealed the presence of hyporeflective dots on the cornea, suggesting that they were cystic. AS-OCT confirmed the subepithelial location of lesions. In all patients, the cornea cleared, and visual acuity recovered fully with a short course of topical steroids and lubricants.

Mirvetuximab soravtansine therapy can cause transient corneal toxicity. A short course of topical steroids can reduce the patient symptoms.