Abstract

Volume.121 Number.1

Original article : Clinical science

The Japan Cornea Society Survey of the Current Status of Corneal and Conjunctival Disorders Due to Systemic Antitumor Drugs
Yoshitsugu Inoue1, Atsushi Shiraishi2, Koji Sugioka3, Norihiko Yokoi4, Tai-ichiro Chikama5, Tohru Sakimoto6, Hiroya Kashiwagi7, Tsugihisa Sasaki8
1 Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
2 Department of Ophthalmology, Ehime University Graduate School of Medicine
3 Department of Ophthalmology, Kinki University Faculty of Medicine
4 Department of Ophthalmology, Kyoto Prefectural University of Medicine
5 Department of Ophthalmology and Visual Science, Hiroshima University Institute of Biomedical & Health Sciences
6 Department of Visual Sciences, Division of Ophthalmology, Nihon University School of Medicine
7 Division of Ophthalmology, Shizuoka Cancer Center
8 Sasaki Eye Clinic

Purpose: To investigate the current status of corneal and conjunctival disorders due to antitumor drugs in Japan.
Methods: Questionnaires on corneal and conjunctival disorders due to antitumor drugs were sent to members of the Japan Cornea Society, and data on patients' background, clinical findings, treatment and prognosis of cases between January 2009 and December 2011 were collected and analyzed. Results: Out of all 221 cases from 66 facilities, TS-1 had been administered in 210 cases (95.0%). Corneal findings were noted in 192 cases (86.9%), including 161cases (72.9%) of superficial punctate keratopathy, 55 cases (24.9%) of epithelial crack line, 38 cases (17.2%) of sheet-like epithelial abnormality, and 15 cases (6.8%) of corneal erosion. Conjunctival and ciliary findings were observed in 49 cases (22.2%). Lacrimal obstruction and constriction were found in 81cases (36.7%). Logistic regression analyses revealed the discontinuation and switching of antitumor drugs as the significant factor of good prognosis of clinical signs and visual acuity in cases with TS-1 administration.
Conclusions: Although corneal and conjunctival disorders due to antitumor drugs, especially TS-1, are important adverse effects, the only effective treatment at this time is the discontinuation and switching of antitumor drugs. Future prospective studies are needed to elucidate pathogenesis, aiming to the prediction and prevention of the occurrence.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121: 23-33, 2017.

Key words
Corneal and conjunctival disorder, Antitumor drug, TS-1, Lacrimal obstruction and constriction
Reprint requests to
Yoshitsugu Inoue, M.D. Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University. 36-1 Nishi-cho, Yonago-shi 683-8504, Japan