Ocular side effects of novel anti-cancer biological therapies.

To examine the ocular side effects of selected biological anti-cancer therapies and the ocular and systemic prognosis of patients receiving them. We retrospectively reviewed all medical records of patients who received biological anti-cancer treatment from 1/2012 to 12/2017 and who were treated at our ocular oncology service. The following data was retrieved: primary malignancy, metastasis, type of biological therapy, ocular side effects, ophthalmic treatment, non-ocular side effects, and ocular and systemic disease prognoses. Twenty-two patients received biological therapies and reported ocular side effects. Eighteen patients (81.8%) had bilateral ocular side effects, including uveitis (40.9%), dry eye (22.7%), and central serous retinopathy (22.7%). One patient (4.5%) had central retinal artery occlusion (CRAO), and one patient (4.5%) had branch retinal vein occlusion (BRVO). At the end of follow-up, 6 patients (27.27%) had resolution of the ocular disease, 13 patients (59.09%) had stable ocular disease, and 3 patients (13.64%) had progression of the ocular disease. Visual acuity improved significantly at the end of follow-up compared to initial values. Eighteen patients (81.8%) were alive at study closure. Biological therapies can cause a wide range of ocular side effects ranging from dry eye symptoms to severe pathologies that may cause ocular morbidity and vision loss, such as uveitis, CRAO and BRVO. All patients receiving biological treatments should be screened by ophthalmologists before treatment, re-screened every 4-6 months during treatment, and again at the end of treatment. Patients on biological treatment who have ocular complaints should be urgently referred to ocular consultation for early identification and early intervention.

Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient.

A 55 year old woman, known to have systemic lupus erythematosus and protein S deficiency, presented with sudden onset of visual loss in the left eye. Three days previously, she took a herbal phytoestrogen preparation for relief of her menopausal symptoms. Ophthalmological assessment showed a left inferior hemiretinal vein thrombosis. The temporal relation between the onset of visual symptoms and ingestion of this herbal preparation suggested that in this patient with a prior non-manifest prothrombotic tendency, there may be an association between the development of retinal vein thrombosis and herbal phytoestrogen use.

Retinal vein occlusion after trabeculectomy with mitomycin C.

PURPOSE: To evaluate acute retinal vein occlusion as a potential complication of trabeculectomy with mitomycin C in cases of advanced glaucoma. METHODS: The records of three patients who developed retinal vein occlusions immediately after uncomplicated trabeculectomy with mitomycin C were reviewed. RESULTS: All three patients had advanced open-angle glaucoma with total cupping of the optic nerve, severe visual field loss, and evidence of systemic vascular disease. A marked decrease in intraocular pressure was noted in the postoperative period in all of the patients. CONCLUSION: A shift in the lamina cribrosa, associated with the perioperative intraocular pressure change, may have contributed to occlusion of the venous outflow system in these susceptible patients.