Ocular side effects of novel anti-cancer biological therapies
Vicktoria Vishnevskia-Dai1, Lihi Rozner2, Raanan Berger3,4
1The Ocular Oncology Service, The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. vivida65@gmail.com.
Abstract:
To examine the ocular side effects of selected biological anti-cancer therapies and the ocular and systemic prognosis of patients receiving them. We retrospectively reviewed all medical records of patients who received biological anti-cancer treatment from 1/2012 to 12/2017 and who were treated at our ocular oncology service. The following data was retrieved: primary malignancy, metastasis, type of biological therapy, ocular side effects, ophthalmic treatment, non-ocular side effects, and ocular and systemic disease prognoses. Twenty-two patients received biological therapies and reported ocular side effects. Eighteen patients (81.8%) had bilateral ocular side effects, including uveitis (40.9%), dry eye (22.7%), and central serous retinopathy (22.7%). One patient (4.5%) had central retinal artery occlusion (CRAO), and one patient (4.5%) had branch retinal vein occlusion (BRVO). At the end of follow-up, 6 patients (27.27%) had resolution of the ocular disease, 13 patients (59.09%) had stable ocular disease, and 3 patients (13.64%) had progression of the ocular disease. Visual acuity improved significantly at the end of follow-up compared to initial values. Eighteen patients (81.8%) were alive at study closure. Biological therapies can cause a wide range of ocular side effects ranging from dry eye symptoms to severe pathologies that may cause ocular morbidity and vision loss, such as uveitis, CRAO and BRVO. All patients receiving biological treatments should be screened by ophthalmologists before treatment, re-screened every 4-6 months during treatment, and again at the end of treatment. Patients on biological treatment who have ocular complaints should be urgently referred to ocular consultation for early identification and early intervention.
Insights
Biological anti-cancer therapies can cause significant ocular side effects, including uveitis and vision loss. Regular ophthalmologist screening is crucial for early detection and intervention in patients undergoing these treatments.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Biological anti-cancer therapies offer targeted treatment but can induce various systemic and ocular side effects.
- Ocular complications associated with these advanced therapies require careful monitoring and management.
- Understanding the spectrum of ocular side effects is vital for patient prognosis.
Purpose of the Study:
- To investigate the ocular side effects of biological anti-cancer treatments.
- To evaluate the ocular and systemic prognosis for patients receiving these therapies.
- To establish screening and management guidelines for ocular complications.
Main Methods:
- Retrospective review of medical records for patients treated with biological anti-cancer therapy between January 2012 and December 2017.
- Data collection included primary malignancy, metastasis, biological therapy type, ocular/non-ocular side effects, ophthalmic treatment, and disease prognoses.
- Analysis of ocular conditions such as uveitis, dry eye, central serous retinopathy, central retinal artery occlusion (CRAO), and branch retinal vein occlusion (BRVO).
Main Results:
- Twenty-two patients experienced ocular side effects, with 81.8% having bilateral involvement.
- Common side effects included uveitis (40.9%), dry eye (22.7%), and central serous retinopathy (22.7%).
- Severe events like CRAO and BRVO occurred in 4.5% of patients; 81.8% were alive at study closure with improved visual acuity.
Conclusions:
- Biological therapies can lead to a broad range of ocular side effects, from mild symptoms to severe vision-threatening conditions.
- Proactive ophthalmic screening before, during, and after treatment is recommended for all patients.
- Urgent ocular consultation is advised for patients experiencing any visual complaints during biological therapy.
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