Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review

Introduction: Two cases of late presentation (>5 years) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibi...

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Main Authors: Christolyn Raj, Lewis Levitz
Format: Article
Language:English
Published: Karger Publishers 2024-01-01
Series:Case Reports in Ophthalmology
Subjects:
Online Access:https://beta.karger.com/Article/FullText/535801
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author Christolyn Raj
Lewis Levitz
author_facet Christolyn Raj
Lewis Levitz
author_sort Christolyn Raj
collection DOAJ
description Introduction: Two cases of late presentation (>5 years) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentation: Case 1 is an 83-year-old female who has been stable on ibrutinib (Imbruvica®) for chronic lymphocytic leukemia. She presented with bilateral blurred vision from severe cystoid macula edema, 7 years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema, 6 years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last 5 years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea, and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.
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spelling doaj.art-8e1477b99d954a0b8e5969b9ac97985c2024-02-01T08:03:26ZengKarger PublishersCase Reports in Ophthalmology1663-26992024-01-01151152210.1159/000535801535801Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature ReviewChristolyn Raj0Lewis Levitz1Vision Eye Institute Camberwell, Melbourne, VIC, AustraliaVision Eye Institute Camberwell, Melbourne, VIC, AustraliaIntroduction: Two cases of late presentation (>5 years) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentation: Case 1 is an 83-year-old female who has been stable on ibrutinib (Imbruvica®) for chronic lymphocytic leukemia. She presented with bilateral blurred vision from severe cystoid macula edema, 7 years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema, 6 years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last 5 years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea, and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.https://beta.karger.com/Article/FullText/535801pseudophakic macula edemakinase inhibitorsocular toxicity
spellingShingle Christolyn Raj
Lewis Levitz
Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
Case Reports in Ophthalmology
pseudophakic macula edema
kinase inhibitors
ocular toxicity
title Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
title_full Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
title_fullStr Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
title_full_unstemmed Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
title_short Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case Series and Literature Review
title_sort late presentation of pseudophakic macula edema from oral kinase inhibitors a case series and literature review
topic pseudophakic macula edema
kinase inhibitors
ocular toxicity
url https://beta.karger.com/Article/FullText/535801
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AT lewislevitz latepresentationofpseudophakicmaculaedemafromoralkinaseinhibitorsacaseseriesandliteraturereview