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Marolo P, Ribero S, Caselgrandi P, Ghilardi A, de Sanctis U, Parisi G, Fallico M, Borrelli E, Ortoncelli M, Gelato F, Mastorino L, Tibaldi T, Roccuzzo G, Quaglino P, Reibaldi M. Ocular Surface Disease in Patients With Atopic Dermatitis Treated With Dupilumab: A Prospective Case-Control Study. Cornea 2024; 43:221-227. [PMID: 37404010 DOI: 10.1097/ico.0000000000003341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE The aim of this study was to evaluate the variation of dry eye disease (DED) prevalence in patients with atopic dermatitis (AD) treated with dupilumab. METHODS This prospective case-control study included consecutive patients with moderate-to-severe AD scheduled for dupilumab between May and December 2021 and healthy subjects. DED prevalence, the Ocular Surface Disease Index, tear film breakup time test, osmolarity, Oxford staining score, and Schirmer test results were collected at baseline, 1 month, and 6 months after dupilumab therapy. The Eczema Area and Severity Index was assessed at baseline. Ocular side effects and discontinuation of dupilumab were also recorded. RESULTS Seventy-two eyes from 36 patients with AD treated with dupilumab and 36 healthy controls were included. Prevalence of DED increased from 16.7% at baseline to 33.3% at 6 months in the dupilumab group ( P = 0.001), whereas it remained unchanged in the control group ( P = 0.110). At 6 months, the Ocular Surface Disease Index and Oxford score increased (from 8.5 ± 9.8 to 11.0 ± 13.0, P = 0.068, and from 0.1 ± 0.5 to 0.3 ± 0.6, P = 0.050, respectively), the tear film breakup time test and Schirmer test results decreased (from 7.8 ± 2.6 s to 7.1 ± 2.7 s, P < 0.001, and from 15.4 ± 9.6 mm to 13.2 ± 7.9 mm, P = 0.036, respectively) in the dupilumab group, whereas they remained stable in the control group ( P > 0.05). Osmolarity was unchanged (dupilumab P = 0.987 and controls P = 0.073). At 6 months after dupilumab therapy, 42% of patients had conjunctivitis, 36% blepharitis, and 2.8% keratitis. No severe side effects were reported, and none of the patients discontinued dupilumab. No association between Eczema Area and Severity Index and DED prevalence was shown. CONCLUSIONS DED prevalence increased in patients with AD treated with dupilumab at 6 months. However, no severe ocular side effects were found and no patient discontinued therapy.
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Affiliation(s)
- Paola Marolo
- Department of Ophthalmology, University of Turin, Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | | | - Andrea Ghilardi
- Department of Ophthalmology, University of Turin, Turin, Italy
| | - Ugo de Sanctis
- Department of Ophthalmology, University of Turin, Turin, Italy
| | | | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy; and
| | | | - Michela Ortoncelli
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Federica Gelato
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Luca Mastorino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Tommaso Tibaldi
- Department of Ophthalmology, University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
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Tibaldi T, Roccuzzo G, Fazio A, Cattani I, Nuzzi R, Quaglino P, Reibaldi M. Visual symptoms in a patient treated with MEK inhibitors. Eur J Ophthalmol 2024; 34:NP144-NP147. [PMID: 36517976 DOI: 10.1177/11206721221145739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2023]
Abstract
PURPOSE to report an uncommon presentation of Encorafenib-Binimetinib retinal side effects. CASE REPORT A 56-year-old Caucasian woman, naïve to previous chemotherapies, was started on Encorafenib/Binimetinib for metastatic melanoma. After seven hours from the first 45 mg Binimetinib dose, the patient developed blurry vision with coloured halos. The symptoms were transient and the following day a complete ophthalmological examination revealed the presence of subretinal fluid (SRF) at Optical coherence tomography (OCT). After one week, the patient remained asymptomatic, with no signs of SRF at the follow up reevaluation. However, six weeks later, the symptoms originally experienced with the first drug intake appeared again. This time fundus examination revealed an irregular macular region. At infrared OCT an almond shaped hyporeflective lesion, surrounded by hyperreflectivity, was demonstrated without signs of SRF. Encorafenib/Binimetinib was continued at the same dose and strict monitoring was scheduled, according to the European Medicine's Agency indication to withhold the drug only in presence of symptomatic retinal pigment epithelial detachment. CONCLUSION Visual symptoms associated with SRF induced by Binimetinib have been described in the literature. In our case, visual symptoms were experienced by the patient at different times, both with and without evidence of SRF. This finding seems to suggest that while Binimetinib-induced SRF is an asymptomatic finding in most cases, with excellent outcome and rapid resolution, visual symptoms could be initially triggered by detectable SRF, yet persist without any further evidence of abnormal fluid accumulation and manifest intermittently.
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Affiliation(s)
- Tommaso Tibaldi
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Alessandra Fazio
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Ilaria Cattani
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Raffaele Nuzzi
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Michele Reibaldi
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
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Rolle T, Ghilardi A, Malinverni L, Tibaldi T, Reibaldi M. Evaluation of tear film Osmolarity in glaucomatous and ocular hypertensive patients under topical therapies: A real life experience of a glaucoma unit. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Teresa Rolle
- Surgical Sciences‐Eye Clinic University of Torino Torino Italy
| | - Andrea Ghilardi
- Surgical Sciences‐Eye Clinic University of Torino Torino Italy
| | | | - Tommaso Tibaldi
- Surgical Sciences‐Eye Clinic University of Torino Torino Italy
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Roccuzzo G, Tibaldi T, Cavallo F, Aquino C, Rolle T, Quaglino P, Ribero S. Retinoid-associated myopia in dermatologic patients: a systematic review. Cutan Ocul Toxicol 2022; 41:318-322. [PMID: 36260481 DOI: 10.1080/15569527.2022.2137177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Systemic retinoids are among the most prescribed drugs in dermatology, thanks to their activity as proliferation modulators and keratinization normalizers. Common side effects such as blood lipid disorders, xerosis and photosensitivity are well established and usually dose dependent. Conversely, retinoid-associated ocular disturbances have been reported, yet with differences in terms of frequency and manifestations. As data regarding a potential correlation with refractive errors are heterogenous and have not been previously thoroughly addressed, we performed a systematic review of the literature with the aim of comprehensively evaluating the current evidence regarding retinoid-associated myopia in dermatologic patients.
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Affiliation(s)
- Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Tommaso Tibaldi
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesco Cavallo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Carola Aquino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Teresa Rolle
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
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