Eye Unit, Southampton General Hospital, Southampton, UK.
Eye Unit, St Bernard's Hospital, Gibraltar, Gibraltar.
Eye (Lond). 2021 Dec;35(12):3277-3284. doi: 10.1038/s41433-020-01379-9. Epub 2021 Jan 28.
To determine the presenting features of ocular surface disease in patients with atopic dermatitis (AD) treated with dupilumab at a tertiary, university hospital. To establish the need for treatment of dupilumab-associated ocular surface disease and report any long-term effects on the ocular surface.
A retrospective analysis of consecutive patients treated with dupilumab for AD between January 2017 and August 2019 was undertaken. Data were collected on demographics, incidence and type of ocular disease features, natural history and treatment.
A total of 50% (14/28) patients developed ocular symptoms with a mean time of onset of 6.75 (±6.1) weeks from starting dupilumab. Of these, 69% (9/13) were diagnosed with conjunctivitis associated with cicatrisation in two patients and periorbital skin changes in four. Of these nine, four had prior history of atopic keratoconjunctivitis. All were treated with topical steroids; two required additional ciclosporin drops. In all, 67% (6/9) patients went on to have on-going ocular inflammation requiring maintenance drops at a mean of 16 (±6.9) months of follow-up. All patients had improvement in their AD severity; only one patient discontinued dupilumab due to ocular side effects.
The rate of dupilumab-associated ocular surface disease was 32%. Periorbital skin changes and conjunctival cicatrisation were noted in association with conjunctivitis. Ocular surface disease improved on topical steroids and ciclosporin but 67% of patients needed on-going treatment. Close liaison with an ophthalmologist should be considered in those patients who develop conjunctivitis or have a past history of severe ocular surface disease.
确定在一家三级大学医院接受度普利尤单抗治疗的特应性皮炎（AD）患者的眼表疾病的表现特征。确定治疗度普利尤单抗相关眼表疾病的必要性，并报告对眼表的任何长期影响。
对 2017 年 1 月至 2019 年 8 月期间接受度普利尤单抗治疗 AD 的连续患者进行回顾性分析。收集人口统计学、眼部疾病特征的发生率和类型、自然病史和治疗数据。
共有 50%（14/28）的患者出现眼部症状，从开始度普利尤单抗到出现症状的平均时间为 6.75（±6.1）周。其中，69%（9/13）的患者被诊断为结膜炎，其中 2 例伴有瘢痕形成，4 例伴有眶周皮肤改变。这 9 例中有 4 例有特应性角结膜炎的既往病史。所有患者均接受局部皮质类固醇治疗；其中 2 例需要额外的环孢素滴眼液。总共 67%（6/9）的患者出现持续的眼部炎症，需要在平均 16（±6.9）个月的随访中维持滴注。所有患者的 AD 严重程度均有所改善；只有 1 例患者因眼部副作用而停止使用度普利尤单抗。
度普利尤单抗相关眼表疾病的发生率为 32%。与结膜炎相关的是眶周皮肤改变和结膜瘢痕形成。眼表疾病在局部皮质类固醇和环孢素治疗后得到改善，但 67%的患者需要持续治疗。对于出现结膜炎或有严重眼表疾病既往史的患者，应考虑与眼科医生密切联系。
