Ocular Side-Effects Associated with Imatinib Mesylate (Gleevec^®)

Abstract

This retrospective case series describes ocular side-effects associated with imatinib mesylate (Gleevec) and the clinical characteristics of these adverse reactions. A chart review of 104 patients on imatinib mesylate therapy from Oregon Health & Science University's Cancer Center were studied with regard to ocular side-effects. In addition, spontaneous reports from the Food and Drug Administration, the World Health Organization, and the National Registry of Drug-Induced Ocular Side-Effects databases were reviewed, including a Medline literature search. Seventy-three (70%) of the patients at OHSU developed periorbital edema and 19 patients (18%) developed epiphora after receiving imatinib mesylate. Average dose was 407.5+/-60 mg. Periorbital edema occurred an average of 68+/-48 days after initiation of therapy. WHO classification of side-effects is as follows: certain: periorbital edema; probable: epiphora; possible: extraocular muscle palsy, ptosis, blepharoconjunctivitis; unlikely: glaucoma, papilledema, retinal hemorrhage, photosensitivity, abnormal vision, and increased intraocular pressure. Periorbital edema and epiphora are the two most common ocular side-effects related to imatinib mesylate therapy. Clinical characteristics of imatinib mesylate induced periorbital edema are described. Management of ocular side-effects is conservative except in very rare cases of visually significant periorbital edema.

Imatinib-induced ophthalmological side-effects in GIST patients are associated with the variations of EGFR, SLC22A1, SLC22A5 and ABCB1

“…22,23 Conjunctival hemorrhage was noted in 14 (11%) patients in the absence of marrow suppression or systemic bleeding tendency, which is consistent with the result in a cohort of 87 GIST patients. 24 In our study, we found, for the first time, that the ocular side effects of Imatinib are independent of plasma concentration and KIT or PDGFRA mutation status, but significantly correlated with the SNPs of EGFR, SLC22A1, SLC22A5 and ABCB1, indicating that these variants might be markers for predicting the ocular toxicity in patients treated with Imatinib.…”

Visual disturbance due to retinal edema as a complication of imatinib

“…Ocular manifestation of edema is a recognized problem associated with imatinib use. 6 However, periorbital edema and epiphora are the two most common complications, and retinal involvement has never been reported. Since PDGF receptors are expressed in the retina, 7 it is reasonable to assume that imatinib may cause retinal edema in some patients.…”

Regional Evaluation of Tolerability and Efficacy of Imatinib Mesylate in Patients with Chronic Phase CML in Mashhad (Iran, Southwest Asia)

“…From 14% of patients who had hemorrhage, 2 patients had subconjunctival hemorrhage, and in others (women) the menstruation period were became intense; after starting imatinib. Eye complication other than periorbital edema were including red eye in 5%, which in one patient was recurrent, and subconjunctival hemorrhage in two patients (3.3%), which were rarely reported in other studies even in the studies that evaluated ocular adverse effects [16] [17]. Subconjunctival hemorrhage in one patient occurred with thrombocytopenia, but the other patient did not have.…”