Ocular surface discomfort likely after paclitaxel treatment

Cancer patients who had completed a course of paclitaxel are at a higher risk of ocular surface discomfort, reports a recent study.

Twenty-nine patients (mean age, 53.6±12.7 years; 93 percent female) participated in the study. All had completed paclitaxel 3–24 months before assessment. The Ocular Surface Disease Index (OSDI) was used to assess ocular surface discomfort, while in-vivo corneal confocal microscopy was used to evaluate corneal nerve parameters. A parallel group of 29 age- and sex-matched healthy controls was also included.

Fifteen paclitaxel patients reported having ocular surface discomfort, as opposed to only five in the healthy controls. The resulting occurrence rates were significantly different (51.7 percent vs 17.2 percent; p=0.006).

The total OSDI score was likewise significantly higher in patients treated with paclitaxel (12.5 vs 0; p=0.007), suggesting that they had worse symptoms of dry eye symptoms. The same was true for the symptom and visual function, but not environment, subdomains of OSDI.

Paclitaxel-treated patients were more than five times as likely as controls to develop ocular surface discomfort (odds ratio, 5.14, 95 percent confidence interval, 1.54–17.21).

In terms of imaging results, patients in the paclitaxel group showed significantly reduced corneal nerve fibre length and inferior whorl length than controls (p=0.04); no such differences were reported for the corneal nerve fibre and branch densities.

“Eye care clinicians should be aware of the ocular surface discomfort in cancer patients treated with neurotoxic chemotherapy, while medical oncologists should be cognizant of such effects in patients who have completed treatment particularly those with persistent peripheral neuropathic symptoms,” the researchers said.