Dupilumab-associated ocular surface disease: presentation, management and long-term sequelae
Dupilumab-associated ocular surface disease: presentation, management and long-term sequelae
OBJECTIVES: To determine the presenting features of ocular surface disease in patients with atopic dermatitis (AD) treated with dupilumab at a tertiary, university hospital. To establish the need for treatment of dupilumab-associated ocular surface disease and report any long-term effects on the ocular surface.
METHODS: A retrospective analysis of consecutive patients treated with dupilumab for AD between January 2017 and August 2019 was undertaken. Data were collected on demographics, incidence and type of ocular disease features, natural history and treatment.
RESULTS: A total of 50% (14/28) patients developed ocular symptoms with a mean time of onset of 6.75 (±6.1) weeks from starting dupilumab. Of these, 69% (9/13) were diagnosed with conjunctivitis associated with cicatrisation in two patients and periorbital skin changes in four. Of these nine, four had prior history of atopic keratoconjunctivitis. All were treated with topical steroids; two required additional ciclosporin drops. In all, 67% (6/9) patients went on to have on-going ocular inflammation requiring maintenance drops at a mean of 16 (±6.9) months of follow-up. All patients had improvement in their AD severity; only one patient discontinued dupilumab due to ocular side effects.
CONCLUSION: The rate of dupilumab-associated ocular surface disease was 32%. Periorbital skin changes and conjunctival cicatrisation were noted in association with conjunctivitis. Ocular surface disease improved on topical steroids and ciclosporin but 67% of patients needed on-going treatment. Close liaison with an ophthalmologist should be considered in those patients who develop conjunctivitis or have a past history of severe ocular surface disease.
3277-3284
Popiela, Magdalena Z
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Barbara, Ramez
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Turnbull, Andrew M J
f783d839-e7cb-4849-a2ac-07588c4613a6
Corden, Emma
66074b0f-fbeb-4722-bc9f-79ffe1827a50
Martinez-Falero, Beatriz Suarez
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O'Driscoll, Daniel
050ca5c3-7996-4a47-b294-4c72cac81d52
Ardern-Jones, Michael R
7ac43c24-94ab-4d19-ba69-afaa546bec90
Hossain, Parwez N
563de5fc-84ad-4539-9228-bde0237eaf51
December 2021
Popiela, Magdalena Z
d8f2ed30-be48-437a-880b-168c0927605a
Barbara, Ramez
46468c8a-4db7-47b0-bd65-1f770d0b1165
Turnbull, Andrew M J
f783d839-e7cb-4849-a2ac-07588c4613a6
Corden, Emma
66074b0f-fbeb-4722-bc9f-79ffe1827a50
Martinez-Falero, Beatriz Suarez
c9b90114-1484-415b-a9e1-99e43bf9f358
O'Driscoll, Daniel
050ca5c3-7996-4a47-b294-4c72cac81d52
Ardern-Jones, Michael R
7ac43c24-94ab-4d19-ba69-afaa546bec90
Hossain, Parwez N
563de5fc-84ad-4539-9228-bde0237eaf51
Popiela, Magdalena Z, Barbara, Ramez, Turnbull, Andrew M J, Corden, Emma, Martinez-Falero, Beatriz Suarez, O'Driscoll, Daniel, Ardern-Jones, Michael R and Hossain, Parwez N
(2021)
Dupilumab-associated ocular surface disease: presentation, management and long-term sequelae.
Eye, 35 (12), .
(doi:10.1038/s41433-020-01379-9).
Abstract
OBJECTIVES: To determine the presenting features of ocular surface disease in patients with atopic dermatitis (AD) treated with dupilumab at a tertiary, university hospital. To establish the need for treatment of dupilumab-associated ocular surface disease and report any long-term effects on the ocular surface.
METHODS: A retrospective analysis of consecutive patients treated with dupilumab for AD between January 2017 and August 2019 was undertaken. Data were collected on demographics, incidence and type of ocular disease features, natural history and treatment.
RESULTS: A total of 50% (14/28) patients developed ocular symptoms with a mean time of onset of 6.75 (±6.1) weeks from starting dupilumab. Of these, 69% (9/13) were diagnosed with conjunctivitis associated with cicatrisation in two patients and periorbital skin changes in four. Of these nine, four had prior history of atopic keratoconjunctivitis. All were treated with topical steroids; two required additional ciclosporin drops. In all, 67% (6/9) patients went on to have on-going ocular inflammation requiring maintenance drops at a mean of 16 (±6.9) months of follow-up. All patients had improvement in their AD severity; only one patient discontinued dupilumab due to ocular side effects.
CONCLUSION: The rate of dupilumab-associated ocular surface disease was 32%. Periorbital skin changes and conjunctival cicatrisation were noted in association with conjunctivitis. Ocular surface disease improved on topical steroids and ciclosporin but 67% of patients needed on-going treatment. Close liaison with an ophthalmologist should be considered in those patients who develop conjunctivitis or have a past history of severe ocular surface disease.
Text
s41433-020-01379-9
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Accepted/In Press date: 16 December 2020
e-pub ahead of print date: 28 January 2021
Published date: December 2021
Additional Information:
© 2021. The Author(s).
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Local EPrints ID: 446793
URI: http://eprints.soton.ac.uk/id/eprint/446793
ISSN: 0950-222X
PURE UUID: e973f597-fc7a-4cb4-b72e-6237e1a3a152
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Date deposited: 23 Feb 2021 17:30
Last modified: 17 Mar 2024 03:10
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Contributors
Author:
Magdalena Z Popiela
Author:
Ramez Barbara
Author:
Andrew M J Turnbull
Author:
Emma Corden
Author:
Beatriz Suarez Martinez-Falero
Author:
Daniel O'Driscoll
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