Cyclosporine for Dry Eye Associated With Nivolumab: A Case Progressing to Corneal Perforation.

Abstract:

PURPOSE:To present the clinical outcome of 2 cases of severe dry eye associated with Nivolumab, with 1 case progressing to corneal perforation. DESIGN:Case report. CASE 1:: A 58-year-old man with metastatic melanoma was referred for the management of severe bilateral dry eyes after undergoing his sixth cycle of Nivolumab. The right eye progressed to corneal perforation 4 weeks after referral, after which Nivolumab was discontinued. When metastatic disease recurred, Nivolumab was continued with an ocular surface stabilized with an intensive regimen that included topical cyclosporine. CASE 2:: A 46-year-old woman with metastatic melanoma was referred for severe dry eye symptoms around the timing of her third cycle of Nivolumab. Improvement of symptoms and surface staining was achieved with a regimen that included aggressive lubrication and topical cyclosporine. On follow-up after completing Nivolumab therapy, metastatic melanoma has remained regressed. CONCLUSIONS:Nivolumab can cause or worsen dry eye disease to the point of corneal perforation. Given that its antitumor effect is immune-mediated, therapies targeting ocular surface inflammation can be effective for stabilizing dry eye disease in patients who continue treatment with Nivolumab.

journal_name

Cornea

journal_title

Cornea

authors

Nguyen AT,Elia M,Materin MA,Sznol M,Chow J

doi

10.1097/ICO.0000000000000724

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

399-401

issue

3

eissn

0277-3740

issn

1536-4798

journal_volume

35

pub_type

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