Refractive Shifts Mimicking Myopic Refractive Surgery With Multiple Myeloma Treatment

To report a case of refractive shifts during multiple myeloma treatment with agent Belantamab Mafodotin (Belamaf).

One-Day Ophthalmology Clinic “ORASI”, Trikala, Central Greece

A 56-year-old man presented in our clinic for a baseline eye examination due to the use of belantamab mafodotin after the referral of his ongologist. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were checked in Snellen Chart. Comprehensive eye examination was also performed in every visit. Corneal tomography was used to record changes of cornea surface.

UCVA was 4/10 in both eyes and BCVA was 10/10 (myopic refractive correction). Slit lamp examination (SLE) showed a mild superficial keratopathy. 2 weeks later the patient presented urgently complaining for visual changes. UCVA was 6/10 and 9/10 in his right and left eye respectively. BCVA was 10/10 with a hyperopic refractive correction. SLE showed a superficial epithelial keratopathy in midperipheral corneas. A corneal tomography showed a midperiphery anterior steepening and a central flattening. A month later, BCVA dropped and treatment was discontinued by the oncologist. BCVA was 10/10 with baseline myopic refractive correction 2 months after discontinuation of therapy and corneal tomographic alterations were also recorded.

It seems that the use of belantamab mafodotin can be related with refractive shifts that can mimic refractive surgery changes. Corneal tomography is mandatory for the record and evaluation of these changes.