Hemorrhagic Chemosis Associated With Isatuximab Use in an Elderly Lady With Multiple Myeloma

Isatuximab is a newly approved targeted therapy for the treatment of patients with advanced multiple myeloma. Infusion reactions happen often with targeted therapies like isatuximab and can be severe or even life-threatening. However, ocular infusion reactions are rare. We report a 75-year-old female who presented with right eye erythema and associated pain and was found to have had a rapid onset of unilateral hemorrhagic chemosis following an initial infusion of isatuximab. She developed erythema in her right eye, associated with pain, swelling, burning, and a foreign body sensation. Visual acuity in the right eye decreased to light perception only within the first few minutes. The infusion was discontinued, and the patient was treated with steroids and intraocular pressure-lowering drugs. She was monitored for 24 hours and then discharged after symptomatic improvement.