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Canalicular obstruction associated with dupilumab
Allan Z Nghiem1, Mahreen Ameen2, Nikolas Koutroumanos2
1Royal Free London NHS Foundation Trust, Pond Street, Belsize Park, London, NW3 2QG, UK. allan.nghiem@doctors.org.uk.
International Ophthalmology
|October 16, 2023
Summary
Dupilumab, a treatment for atopic dermatitis, can cause canalicular obstruction. This case series highlights treatment outcomes and suggests early ophthalmologist referral may prevent severe ocular complications.
Area of Science:
- Ophthalmology
- Dermatology
- Pharmacology
Background:
- Dupilumab is a biologic therapy for severe atopic dermatitis.
- Ocular complications, including blepharoconjunctivitis and punctal stenosis, are associated with dupilumab use.
- Canalicular obstruction represents a significant, though less common, ocular side effect.
Purpose of the Study:
- To report cases of canalicular obstruction in patients treated with dupilumab.
- To describe the treatment strategies and outcomes for these patients.
- To contribute to the understanding of dupilumab-associated ocular complications.
Main Methods:
- Retrospective case series of four patients.
- Diagnosis of canalicular obstruction by an oculoplastic consultant.
- Documentation of interventions including nasolacrimal intubation, conservative management, and endonasal dacryocystorhinostomy with stenting.
Main Results:
- Canalicular obstruction occurred between 3.25 and 4.75 years after starting dupilumab.
- Successful symptom resolution was achieved in three patients following nasolacrimal intubation or endonasal dacryocystorhinostomy.
- One patient remained symptomatic despite endonasal dacryocystorhinostomy with stenting.
Conclusions:
- Canalicular obstruction is a potential ocular complication of dupilumab therapy.
- Optimal treatment strategies are still evolving; conservative measures and surgical interventions show variable success.
- Early ophthalmological evaluation and management may mitigate risks and improve outcomes for patients on dupilumab.
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