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Quantitative Ocular Surface Changes in Patients Undergoing Immune Checkpoint Inhibitor Therapy
Kevin Chen1, Maria Carolina Ibañez Bruron2, Sebastian Mondaca3
1Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Purpose:
To describe the clinical course and evaluate treatment of ocular surface changes in patients receiving immune checkpoint inhibitor (ICI) therapy.
Methods:
Multiple markers of ocular surface dryness were evaluated in 16 patients on ICI therapy. The Wilcoxon rank-sum test was used to determine the significant change in the initial and final ocular surface indices.
Results:
Fifty percent of the eyes demonstrated worsening Schirmer I scores; 29% showed an increase in lissamine green staining. During follow-up, 43% of patients experienced a decline in OSDI scores. Treatments included preservative-free artificial tears (88%), cyclosporine (25%), topical corticosteroids (31%), warm compresses (25%); punctal plugs (13%). Median follow-up time was 3.4 months (range:0-79 ); median ICI treatment duration was 7 months (range:1-40). Four patients died during the observation period.
Conclusion:
A significant proportion of patients experience changes in ocular surface markers while treated with ICIs. Medical intervention can lead to stabilization of ocular surface disease.
Insights
Immune checkpoint inhibitor (ICI) therapy can cause ocular surface changes, including dryness. Treatments like artificial tears and corticosteroids can help stabilize these conditions in patients undergoing ICI treatment.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) are increasingly used in cancer therapy.
- Ocular surface complications are a potential side effect of ICI treatment.
- Understanding these effects is crucial for patient management.
Purpose of the Study:
- To describe the clinical course of ocular surface changes in patients receiving ICI therapy.
- To evaluate the effectiveness of various treatments for these ocular surface conditions.
Main Methods:
- Evaluation of multiple ocular surface dryness markers in 16 patients on ICI therapy.
- Statistical analysis using the Wilcoxon rank-sum test to assess changes in ocular surface indices.
- Assessment of treatment interventions including artificial tears, cyclosporine, corticosteroids, warm compresses, and punctal plugs.
Main Results:
- 50% of eyes showed worsening Schirmer I scores, and 29% had increased lissamine green staining.
- 43% of patients experienced a decline in Ocular Surface Disease Index (OSDI) scores.
- Common treatments included artificial tears (88%), cyclosporine (25%), and topical corticosteroids (31%).
Conclusions:
- A significant number of patients on ICI therapy develop ocular surface changes.
- Medical interventions can effectively stabilize ocular surface disease in this patient population.
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