Abstract ID: 26-395
Acute Reversible Sight-Threatening Ocular Surface Toxicity Associated with Selpercatinib
Author: Zeynep Gizem Bayram Base Hospital / Institution: Istanbul Faculty of Medicine, Istanbul University
Presentation Type: ePoster Presentation
Purpose
To report an acute, severe and reversible ocular surface toxicity temporally associated with selpercatinib, and to emphasize the importance of early recognition of this potentially sight-threatening adverse effect in oculoplastic and ocular surface practice.
Methods
A retrospective case review was performed of a 36-year-old man with multiple endocrine neoplasia type 2B and medullary thyroid carcinoma who developed rapidly progressive bilateral ocular surface disease shortly after initiating selpercatinib. Clinical findings, ophthalmic interventions, systemic treatment modification and visual outcomes were evaluated.
Results
Within 48 hours of treatment initiation, the patient developed acute bilateral visual deterioration, central corneal epithelial defects and diffuse severe punctate epitheliopathy. Despite intensive local treatment, including frequent lubrication, autologous serum, therapeutic contact lenses and temporary tarsorrhaphy, epithelial healing was not achieved while selpercatinib was continued. Following multidisciplinary discussion, selpercatinib was discontinued. Rapid and complete re-epithelialization subsequently occurred, with full restoration of visual acuity to 1.0 in both eyes. The close temporal relationship between drug exposure, treatment resistance, drug withdrawal and complete recovery supported selpercatinib-related ocular surface toxicity.
Conclusion
Selpercatinib may rarely be associated with severe ocular surface toxicity causing rapid visual decline and persistent epithelial defects despite aggressive local therapy. This case highlights that, in selected patients, withdrawal of the offending systemic agent may be the critical step leading to recovery. Awareness of this reversible complication and timely multidisciplinary communication may prevent prolonged epithelial breakdown, unnecessary escalation of ocular procedures and permanent visual morbidity.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mehmet Serhat | Mangan | Istanbul Faculty of Medicine, Istanbul University |
| Semih | Çakmak | Istanbul Faculty of Medicine, Istanbul University |
| Adem | Tellioğlu | Istanbul Faculty of Medicine, Istanbul University |