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Vortex keratopathy associated with ribociclib

Alper Türkel1, Sibel Özdoğan2, Emre Yekedüz1

  • 1Division of Medical Oncology, 146995Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|May 16, 2022
PubMed
Abstract

Insights

Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors, like ribociclib, can cause rare eye side effects such as vortex keratopathy in breast cancer patients. Early detection through regular eye exams is crucial for effective management of these visual disturbances.

Area of Science:

  • Ophthalmology
  • Oncology
  • Pharmacology

Background:

  • Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors represent a new class of drugs for hormone receptor-positive (HR) and human epidermal growth factor receptor 2 (HER-2)-negative breast cancer.
  • These inhibitors offer improved progression-free survival over standard therapies, but common side effects include neutropenia, nausea, leukopenia, fatigue, and diarrhea.
  • Vortex keratopathy is identified as a rare ocular side effect in patients undergoing treatment with CDK4/6 inhibitors, specifically ribociclib.

Observation:

  • A 68-year-old female with advanced HR+/HER2- breast cancer developed blurred vision after initiating ribociclib and fulvestrant treatment.
  • Ophthalmic examination revealed bilateral vortex keratopathy, characterized by subepithelial haze and whorl-like opacities, more pronounced in the left eye.

Findings:

  • Ribociclib treatment was discontinued upon observation of vortex keratopathy.
  • No changes in corneal appearance or visual acuity were noted during the subsequent one-month follow-up period.

Implications:

  • This case highlights vortex keratopathy as a rare but potential ocular side effect of ribociclib in breast cancer patients.
  • Regular ophthalmological monitoring is recommended for patients undergoing CDK4/6 inhibitor therapy to facilitate early detection and management of adverse events.
Keywords:
Ribociclibbreast cancercombination treatmentcyclin-dependent kinases 4 and 6vortex keratopathy

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