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Updated: Mar 8, 2026
07:23
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
8.8K
Risks of Retinal Vascular Occlusions with the Systemic Use of Tyrosine Kinase Inhibitors
Hejin Jeong1, Sophie C Yue2, David C Kaelber3
1Case Western Reserve University School of Medicine, Cleveland, Ohio; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Ophthalmology. Retina
|March 6, 2026
Summary
Systemic tyrosine kinase inhibitor (TKI) therapy, particularly anti-VEGF TKIs, is linked to an increased risk of central retinal vein occlusion (CRVO). Patients on anti-VEGF TKIs require closer ophthalmological monitoring for CRVO during treatment.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Systemic tyrosine kinase inhibitors (TKIs) are used in cancer therapy.
- Previous reports suggest potential links between TKIs and retinal vascular events like central retinal vein occlusion (CRVO).
- Evidence is primarily based on case reports, necessitating further investigation.
Purpose of the Study:
- To investigate the association between systemic TKI therapy and the risks of retinal artery occlusion (RAO) and retinal vein occlusion (RVO).
- To differentiate risks based on whether TKIs have anti-vascular endothelial growth factor (anti-VEGF) activity.
Main Methods:
- Retrospective cohort study utilizing multi-institutional electronic health records.
- Included adult cancer patients without prior retinal vascular occlusions or maculopathy.
- Propensity-score matching compared TKI users (with and without anti-VEGF activity) against non-TKI antineoplastic controls.
Main Results:
- Anti-VEGF TKI use was associated with a significantly higher hazard of CRVO within three years (HR=2.86).
- No significant difference in overall RAO or RVO risk was observed between anti-VEGF TKI users and controls.
- Non-anti-VEGF TKI use showed a lower risk for RAO (RR=0.61) and BRVO (RR=0.51) compared to non-TKI controls, with no difference in 3-year hazard rates.
Conclusions:
- Patients initiating anti-VEGF TKIs may require enhanced ophthalmological surveillance for CRVO.
- Non-anti-VEGF TKIs appear to have a comparable or potentially safer profile regarding RAO and BRVO compared to other antineoplastics.
- Further research is warranted to fully elucidate the ocular risks associated with different classes of TKIs.
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