UNASSIGNED: A 65-year-old woman with non-small cell lung cancer (NSCLC) and bone metastases, without pre-existing ocular conditions, experienced mild dry eye symptoms 1 month following treatment with sintilimab (200 mg q3w) in combination with anlotinib (12 mg q3w). Unrelieved dry eye symptoms occurred after the third cycle of chemotherapy, and she was diagnosed with dry eye syndrome. Subsequently, she received corneal protective lens, sodium hyaluronate eye drops, and prednisone treatment. Her corneal epithelial damage did not improve significantly, and within the following 2 months, her vision decreased in both eyes and progressed to bilateral corneal ulcers. Oral administration of sintilimab and anlotinib was interrupted, and treatments such as corticosteroids, anti-inflammatory drugs, and corneal repair were administered; however, both eyes presented with corneal subepithelial defect and corneal scarring. Due to a shortage of donors, no corneal transplantation surgery could be performed.
UNASSIGNED: The development of corneal epithelial disorders in patients receiving target therapy and immunotherapy may not be reversed by reducing its dose. Although the condition is controlled with the use of glucocorticoids, some eye side effects cannot be cured. The timely detection and intervention of adverse effects of anti-tumor drugs by oncologists and ophthalmologists is critical for rational prescription. Ophthalmologists should be aware of eye side effects in patients using immunotherapy to ensure appropriate treatment and minimize potential eye complications such as dry eye, conjunctivitis, etc.
■一名65岁女性患有非小细胞肺癌(NSCLC)和骨转移,没有预先存在的眼部疾病,在使用辛替尼(200mgq3w)与安洛替尼(12mgq3w)联合治疗1个月后出现轻度干眼症状。第3周期化疗后出现未缓解的干眼症状,她被诊断出患有干眼症.随后,她接受了角膜保护镜,透明质酸钠滴眼液,和泼尼松治疗。她的角膜上皮损伤没有明显改善,在接下来的两个月内,她的双眼视力下降,进展为双侧角膜溃疡。口服辛替利玛和安洛替尼被中断,和皮质类固醇等治疗方法,抗炎药,和角膜修复;然而,双眼均出现角膜上皮下缺损和角膜瘢痕。由于捐助者的短缺,无法进行角膜移植手术.
■接受靶向治疗和免疫治疗的患者角膜上皮疾病的发展可能无法通过减少剂量来逆转。尽管使用糖皮质激素可以控制病情,一些眼睛副作用无法治愈。肿瘤学家和眼科医生及时发现和干预抗肿瘤药物的不良反应是合理处方的关键。眼科医生应该意识到使用免疫疗法的患者的眼睛副作用,以确保适当的治疗并最大程度地减少干眼症等潜在的眼部并发症,结膜炎,等。