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Belantamab mafodotin associated corneal microcyst-like epithelial changes
Katherine Chuang1, Roberto Pineda2, Shaohui Liu1
1Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, 1160 W. Michigan St., Indianapolis, IN, USA.
American Journal of Ophthalmology Case Reports
|February 24, 2022
Summary
Belantamab mafodotin (belamaf) therapy can cause reversible corneal microcyst-like changes in multiple myeloma patients. These ocular side effects necessitate careful monitoring and collaboration between ophthalmologists and oncologists.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Belantamab mafodotin (belamaf) is an FDA-approved treatment for relapsed or refractory multiple myeloma.
- Ocular adverse effects are known complications of belamaf therapy.
Purpose of the Study:
- To report a case of bilateral corneal microcyst-like epithelial changes associated with belantamab mafodotin therapy.
- To highlight the potential for reversible ocular toxicity.
Main Methods:
- A case study of a 70-year-old man with refractory multiple myeloma receiving belamaf.
- Clinical observation of visual acuity and corneal changes.
- Anterior segment optical coherence tomography (OCT) for detailed corneal imaging.
- Treatment interruption and re-challenge with belamaf to assess causality.
Main Results:
- The patient developed decreased visual acuity and bilateral corneal microcyst-like peripheral epithelial changes during belamaf treatment.
- Anterior segment OCT revealed intra-epithelial opacities.
- Corneal changes resolved upon belamaf discontinuation and recurred upon re-initiation.
- Resolution time for corneal changes increased with subsequent infusions, suggesting cumulative effects.
Conclusions:
- Ocular adverse effects, including corneal microcyst-like changes, are associated with belamaf therapy.
- Close collaboration between ophthalmologists and hematologist-oncologists is crucial for managing patients on belamaf.
- Further research is needed to elucidate the mechanism of these corneal changes and their impact on limbal stem cells.
