Cytarabine-Induced Corneal Toxicity: Clinical Features and Relief of Symptoms with Loteprednol Etabonate 0.5% in Two Patients

Ozcan G., Ucakhan Ö. Ö.

TURK OFTALMOLOJI DERGISI-TURKISH JOURNAL OF OPHTHALMOLOGY, cilt.51, sa.2, ss.114-117, 2021 (ESCI) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 51 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.4274/tjo.galenos.2020.99248
  • Dergi Adı: TURK OFTALMOLOJI DERGISI-TURKISH JOURNAL OF OPHTHALMOLOGY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.114-117
  • Anahtar Kelimeler: Acute myeloid leukemia, cytarabine, cytarabine-induced corneal toxicity, corneal microcysts, loteprednol erabonace, in vivo confocal microscopy, CYTOSINE-ARABINOSIDE, THERAPY
  • Ankara Üniversitesi Adresli: Evet

Özet

We report two patients who developed toxic keratopathy following high-dose cytarabine chemotherapy and whose symptoms resolved following topical loteprednol etabonate 0.5% treatment. A 25-year-old woman and a 26-year-old man with acute myeloid leukemia were referred co our department with symptoms of ocular discomfort, phocophobia, and blurred vision after consolidation chemotherapy. Central corneal epithelial microcysts were observed bilaterally in both patients, and in vivo confocal microscopy showed highly reflective disseminated granular and irregular intraepithelial opacities, mainly in the basal epithelial layers. Loteprednol etabonate 0.5% relieved both patients' symptoms in less than a week, and the microcysts disappeared in 2 to 3 weeks of treatment. Although there is no standardized treatment protocol for cytarabine-induced corneal toxicity, dexamethasone 0.1% and prednisolone phosphate 1.0% were reported co be effective in the resolution of discomfort and symptoms. In the two patients we report herein, loteprednol ecabonate 0.5% four times daily was also effective in suppressing the symptoms.