Effects of systemic targeted immunosuppressive therapy on ocular surface

Area of Science:

• Ophthalmology
• Immunology
• Pharmacology

Background:

• Systemic immunotherapies are increasingly used for various conditions.
• These therapies can lead to significant ocular side effects.
• Awareness of these adverse events is crucial for patient care.

Purpose of the Study:

• To review corneal manifestations associated with targeted systemic immunotherapies.
• To provide management guidelines for these ocular side effects.

Main Methods:

• Literature review of ocular side effects from systemic immunotherapies.
• Analysis of reported corneal changes and their association with specific drug classes.

Main Results:

• Tyrosine kinase inhibitors can cause vortex keratopathy.
• Cytarabine and belantamab mafodotin may lead to epithelial microcysts.
• Programmed death 1 inhibitors are linked to corneal perforations, and epidermal growth factor inhibitors to eyelid cicatrization.
• Conjunctivitis is common and usually responds to lubrication and corticosteroids.
• While most effects are anterior segment related, retinal and optic nerve damage can occur.

Conclusions:

• Systemic immunosuppression can cause diverse ocular surface and corneal changes.
• Close ophthalmologic monitoring is essential due to the potential for permanent vision impairment.