Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY.
Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, NY.
Cornea. 2022 Jun 1;41(6):792-801. doi: 10.1097/ICO.0000000000002934. Epub 2021 Nov 23.
Antibody-drug conjugates (ADCs) are a class of cancer drug wherein some are associated with corneal abnormalities, but there is a dearth of published information on refractive shifts in patients receiving ADCs. Here, we evaluated the dynamics of refractive error and keratometry readings in patients with ADC-related keratopathy and microcyst-like epithelial changes (MECs).
This study is a retrospective case series including 58 eyes of 29 patients with ADC-related keratopathy from a single tertiary care cancer referral center (MSKCC). One eye (29 total) was randomly assigned for statistical analysis. In addition, a subset analysis of MEC location-refractive error correlation was performed on 20 eyes. Clinical records including slitlamp examination, indirect ophthalmoscopy, calculated spherical equivalence (SE), keratometry, and visual acuity were recorded at baseline, during, and off treatment.
A subset analysis of MEC location-refractive error correlation of 20 eyes revealed the following: Peripheral MECs were significantly associated with hyperopic shifts (P value < 0.001) and paracentral/central associated with myopic shifts (P value < 0.001). In the full cohort and on drug, the greatest change in SE from baseline was myopic (68%, as high as -4.75 D) and hyperopic (32%, as much as +3.75 D). Eighty-nine percent had a change in vision from baseline while on drug, but at the 3-month follow-up off drug, SE and vision returned to baseline in 33% and 82% of eyes.
Peripheral MECs were significantly associated with hyperopic shifts, and paracentral/central MECs were associated with myopic shifts. While on drug, most eyes had a myopic refractive shift, which corresponded with corneal steepening.
抗体药物偶联物（ADC）是一类癌症药物，其中一些与角膜异常有关，但关于接受 ADC 治疗的患者的屈光变化，发表的信息很少。在这里，我们评估了与 ADC 相关的角膜病变和微囊样上皮改变（MEC）患者的屈光不正和角膜曲率读数的动态变化。
这项研究是一项回顾性病例系列研究，包括来自单一三级癌症转诊中心（MSKCC）的 29 名患者的 58 只眼与 ADC 相关的角膜病变。一只眼（共 29 只）被随机分配用于统计分析。此外，还对 20 只眼的 MEC 位置-屈光不正相关性进行了亚组分析。在基线、治疗期间和治疗结束时，记录临床记录，包括裂隙灯检查、间接检眼镜检查、计算的等效球镜（SE）、角膜曲率和视力。
20 只眼的 MEC 位置-屈光不正相关性亚组分析显示：周边 MEC 与远视漂移显著相关（P 值<0.001），旁中心/中心 MEC 与近视漂移显著相关（P 值<0.001）。在全队列和用药期间，SE 从基线的最大变化为近视（68%，高达-4.75 D）和远视（32%，高达+3.75 D）。89%的患者在用药期间视力较基线发生变化，但在停药后 3 个月的随访中，33%和 82%的患者 SE 和视力恢复到基线。
周边 MEC 与远视漂移显著相关，旁中心/中心 MEC 与近视漂移相关。在用药期间，大多数患者出现近视性屈光变化，这与角膜变陡相对应。
