Favorable Management of Repeated Serous Retinal Detachment with Continued Tumor Response in a Patient with Intrahepatic Cholangiocarcinoma during Treatment with Pemigatinib.

Pemigatinib is a fibroblast growth factor receptor inhibitor (FGFRi) approved for the treatment of patients with previously treated biliary tract cancer with FGFR2 fusion. Although infrequent, ocular toxicity manifested as serous retinal detachment (SRD) has been observed and is regarded as a serious side effect. We herein report the case of a 54-year-old woman with unresectable cholangiocarcinoma-initiated pemigatinib after failure of gemcitabine plus S-1 (GS). Although the patient experienced repeated SRD after pemigatinib, dose interruption and dose reduction of pemigatinib from 13.5 mg to 9 mg, and from 9 mg to 4.5 mg led to complete recovery of SRD, and continued tumor shrinkage.

Thyroid-associated Orbitopathy: Quantitative Evaluation of the Orbital Fat Volume and Edema Using IDEAL-FSE.

BACKGROUND AND PURPOSE: To compare orbital quantitative data obtained by fast spin-echo iterative decomposition of water and fat with echo asymmetry and least-squares estimation (FSE-IDEAL) in patients with thyroid-associated orbitopathy (TAO) and healthy controls and to investigate the characteristics of these data in TAO patients. MATERIALS AND METHODS: Twenty-two TAO patients (4 males and 18 females; median age 51.0 years) and 22 healthy subjects (5 males and 17 females; median age 50.5 years) underwent orbital T2-weighted FSE-IDEAL. The water fraction in orbital fat was defined as the signal intensity (SI) water / (SI water + SI fat). The orbital fat volume was measured on fat images. The degree of proptosis was evaluated using in-phase imaging. Mann-Whitney U test was used to compare these quantitative data in the two groups. In TAO patients we ascertained the correlation among these values with the Spearman's rank correlation coefficient. RESULTS: In TAO patients, the water fraction (right and left, p = 0.04), fat volume (right and left, p = 0.03) and degree of proptosis (right and left, p < 0.01) were higher than in the controls. In TAO patients, only the water fraction and the fat volume of left orbit showed negative correlation (p = 0.01). CONCLUSION: The water fraction of orbital fat, the orbital fat volume and the degree of proptosis obtained with FSE-IDEAL were higher in TAO patients than in the controls. The water fraction was a new parameter for differentiating between TAO patients and healthy subjects.

Twenty-four-hour ocular hypotensive effects of 0.0015% tafluprost and 0.005% latanoprost in healthy subjects.

PURPOSE: To compare the intraocular pressure (IOP) reduction over 24 h achieved with tafluprost (0.0015%) with that achieved with latanoprost (0.005%). METHODS: Twenty-seven healthy volunteers were studied. After a 24-h IOP baseline measurement was taken, one ophthalmic solution was applied to the right eye daily for 7 days. The drug was then withdrawn for 2 weeks. The other agent was then applied to the left eye in the same manner. IOP was measured every 3 h for 24 h on the seventh day of treatment. RESULTS: The 24-h IOP after 7 days' treatment with latanoprost decreased from 11.5 mmHg at baseline to 9.7 mmHg (-1.8 mmHg) and that with tafluprost from 11.8 to 9.8 mmHg (-1.9 mmHg). Tafluprost was statistically more effective after 24 h (P = 0.007; paired t test). The number of subjects with a 24-h mean IOP reduction of <10% was 8/27 (29.6%) with latanoprost versus 4/27 (14.8%) with tafluprost. The incidence of conjunctival hyperemia with latanoprost was 4/27 (14.8%) and that with tafluprost was 8/27 (29.6%). CONCLUSION: The overall efficacies of the two agents were not different, but tafluprost was associated with a greater reduction in IOP at 24 h after administration. Tafluprost showed a higher rate of conjunctival hyperemia.

Efficacy of latanoprost when stored at room temperature.

We compared the ocular hypotensive effect for 24 hours and the tolerability of latanoprost stored at 4 degrees C and 30 degrees C. Seventeen healthy volunteers were included in this crossover trial. Latanoprost 0.005% (Xalatan) was stored at 4 degrees C or 30 degrees C for 4 weeks in the dark. The subjects enrolled to the study were randomly assigned to receive either latanoprost stored at 4 degrees C or that stored at 30 degrees C. The eye drop was applied to the right eye of each subject for 3 days. The left eye served as a control without administration. Slit-lamp biomicroscopy and circadian intra ocular pressure (IOP) curve was performed at Day 3, every 3 hours from 6 pm. This procedure was repeated 7 days after changing the drug from 4 degrees C to 30 degrees C or vice versa, and application to the left eye for 3 days. Eyes treated with latanoprost, stored both at 4 degrees C and 30 degrees C, achieved statistically significantly lower mean IOPs than untreated eyes at all time points, except at 21 hours treated by the drug stored at 30 degrees C. We subtracted the IOP of eyes receiving latanoprost from the IOP of untreated eyes for each time point to evaluate the efficacy of the eye drops (delta IOP). There were no statistically significant differences between the delta IOPs with the drug stored at 4 degrees C and 30 degrees C. During the study, no subject developed a serious adverse event. These results suggest that latanoprost stored at 30 degrees C for 4 weeks after opening the bottle remains as effective and safe as latanoprost stored under cold conditions.