Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-05-06 DOI:10.1007/s40123-025-01147-6

Jakob Schweighofer, Hermine Agis, Maria Krauth, Ruth Donner, Marion Funk, Jan Lammer, Michal Klimek, Gerald Schmidinger, Julia Aschauer

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Abstract

Introduction: This prospective case series investigated corneal epithelial and subbasal nerve plexus changes associated with belantamab mafodotin (Belamaf) therapy in patients with refractory/relapsed multiple myeloma using a multimodal imaging approach.

Methods: We included eight patients (mean age 66 ± 10) scheduled for Belamaf who were monitored for at least three treatment cycles. Standard clinical eye exams with Snellen best corrected visual acuity (BCVA) measurements were complemented by epithelial thickness mapping, slit lamp photography, corneal sensitivity testing, and corneal confocal microscopy.

Results: The mean drop in BCVA was limited to 1 line (20/25 to 20/32) with mean loss in sensitivity from 5.2 ± 0.4 to 8.7 ± 3.4 mg/S. Corneal epithelial thickness increased (from a mean of 62 ± 4.7 to 74 ± 6.2 μm) presenting an irregular pattern from the apex to the mid-periphery. All patients developed microcystic epithelial changes and ocular surface disease. Confocal microscopy revealed a decrease in mean nerve fiber length and density from 12.46 ± 4.94 mm/mm² and 21.87 ± 10.27/mm² at baseline to 3.27 ± 3.9 mm/mm² and 1.78 ± 3.22/mm² at last follow-up, respectively, with preserved limbal architecture.

Conclusion: This prospective study confirms and further characterizes the pathognomonic epithelial changes caused by Belamaf, which are accompanied by severe impairment in subbasal nerve fiber architecture, indicating a neurotoxic effect of the medication that requires further investigation.

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贝兰塔单抗治疗患者的角膜发现：关注角膜神经的前瞻性病例系列。

本前瞻性病例系列研究了难治性/复发性多发性骨髓瘤患者贝兰他单抗（Belamaf）治疗后角膜上皮和基底下神经丛的变化。方法：我们纳入了8例（平均年龄66±10岁）计划接受Belamaf治疗的患者，并对其进行了至少三个治疗周期的监测。标准临床眼科检查采用Snellen最佳矫正视力（BCVA）测量，辅以上皮厚度测量、裂隙灯摄影、角膜灵敏度测试和角膜共聚焦显微镜。结果：BCVA的平均下降限制在1条线（20/25至20/32），平均敏感性下降从5.2±0.4至8.7±3.4 mg/S。角膜上皮厚度从平均62±4.7 μm增加到74±6.2 μm，呈现从顶点到中周的不规则分布。所有患者均出现微囊性上皮改变和眼表疾病。共聚焦显微镜显示，平均神经纤维长度和密度分别从基线时的12.46±4.94 mm/mm2和21.87±10.27 mm/mm2减少到最后随访时的3.27±3.9 mm/mm2和1.78±3.22/mm2，保留了角膜缘结构。结论：本前瞻性研究证实并进一步表征了Belamaf引起的病理上皮改变，并伴有基底下神经纤维结构的严重损害，表明该药的神经毒性作用有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. 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