Haydarpaşa Numune Training and Research Hospital, Sadık Eratik Eye Clinic, İstanbul, Turkey
Turk J Ophthalmol. 2022 Feb 23;52(1):72-74. doi: 10.4274/tjo.galenos.2021.73004.
There is no consensus on the choice of systemic and ophthalmic treatment for patients who develop ocular toxicity with erlotinib in the few cases reported previously. Various ocular complications related to erlotinib have been reported, with one of the most serious being corneal perforation. Our patient was at risk of potential corneal perforation because of severe cicatricial ectropion and diffuse punctate corneal epitheliopathy. Therefore, erlotinib treatment was temporarily discontinued with the approval of the oncology department and the patient was closely followed. She was prescribed steroid eye ointment, single-use preservative-free artificial tears, and eye lubricant gel to protect the ocular surface. On day 4 of treatment, the patient's findings were significantly improved. After 1 week, the cicatricial ectropion had dramatically improved and the patient's complaints were completely resolved. To our knowledge, there is no case report of a patient with both ocular toxicity after long-term use that shows dramatic improvement with drug cessation, and severe cicatricial ectropion affecting the entire lower eyelid. Here, we described a patient who used erlotinib for 3 years due to non-small cell lung cancer and developed severe cicatricial ectropion which improved dramatically within one week of temporarily discontinuing erlotinib and discussed the possible reasons. Although ocular complications with erlotinib are usually encountered early in treatment, it should be kept in mind that erlotinib-related ocular complications may also arise with long-term use.
目前对于既往少数报道的厄洛替尼所致眼部毒性患者的全身及眼部治疗选择尚未达成共识。曾报道多种与厄洛替尼相关的眼部并发症，其中最严重的是角膜穿孔。我们的患者由于严重的瘢痕性眼睑外翻和弥漫性点状角膜上皮病变，存在潜在的角膜穿孔风险。因此，在肿瘤学部门的批准下，暂时停止了厄洛替尼治疗，并对患者进行了密切随访。她被开具了皮质类固醇眼膏、单次使用无防腐剂人工泪液和眼用润滑剂凝胶来保护眼表面。治疗第 4 天，患者的病情明显改善。1 周后，瘢痕性眼睑外翻明显改善，患者的抱怨完全消失。据我们所知，目前尚无长期使用厄洛替尼后出现眼部毒性且停药后明显改善，以及严重的瘢痕性眼睑外翻累及整个下眼睑的病例报告。在此，我们描述了 1 例因非小细胞肺癌使用厄洛替尼 3 年的患者，发生严重的瘢痕性眼睑外翻，在停止厄洛替尼治疗 1 周内明显改善，并讨论了可能的原因。尽管厄洛替尼相关的眼部并发症通常在治疗早期出现，但应注意的是，厄洛替尼相关的眼部并发症也可能在长期使用后发生。
