Superficial Punctate Keratoepitheliopathy Under Treatment with Erlotinib and Lapatinib

Eun Kyu Oh; Dong Hyun Jo; Mee Kum Kim; Won Ryang Wee

doi:10.3341/jkos.2014.55.2.293

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Oh, Jo, Kim, and Wee: Superficial Punctate Keratoepitheliopathy Under Treatment with Erlotinib and Lapatinib

Original Article

J Korean Ophthalmol Soc 2014;55(2):293-297.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.2.293

Superficial Punctate Keratoepitheliopathy Under Treatment with Erlotinib and Lapatinib

Eun Kyu Oh, MD^1,², Dong Hyun Jo, MD^1,², Mee Kum Kim, MD, PhD^1,², Won Ryang Wee, MD, PhD^1,²

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea

Address reprint requests to Mee Kum Kim, MD, PhD Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea, Tel: 82-2-2072-2665, Fax: 82-2-741-3187, E-mail: kmk9@snu.ac.kr

Received 25 May 201315 October 2013 Accepted 8 January 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the corneal superficial punctate keratoepitheliopathy in 2 patients taking the epidermal growth factor re-ceptor (EGFR) inhibitors, erlotinib and lapatinib, respectively.

Case summary

Case 1, who received erlotinib, showed trichomegaly without touching the cornea and diffuse punctate keratoepitheliopathy. Corneal epitheliopathy and the corresponding symptoms resolved after discontinuation of the drug then recurred with reapplication. Case 2 presented diffuse corneal punctate epithelial erosions that developed without any cilia involvement after the patient was administered lapatinib. The visual acuity of both patients was not severely dimin-ished and keratoepitheliopathy was mostly resolved with the treatment of preservative-free artificial tears and autologous serum eye drops.

Conclusions

Erlotinib and lapatinib are both likely to cause visually tolerable corneal punctate keratoepitheliopathy which can be resolved with appropriate topical treatment.

Keywords: Cancer treatment, Corneal erosion, Epidermal growth factor

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Figure 1.

Case 1 using erlotinib showed punctate epithelial erosions on the inferior halves of the cornea in both eyes at initial examinations (A: right eye, C: left eye). With preservative-free artificial tears and autologous serum eye drops, erosions nearly all disappeared (B: right eye, D: left eye).

Figure 2.

Case 2 showed diffuse punctuate keratopathy in both eyes after taking lapatinib for 6 months (A: right eye, B: left eye). After 3 month treatment, the erosions decreased (C: right eye, D: left eye).

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