ESCRS - FP11.03 - Ocular Surface Disease And Its Impact In Patients Treated With Dupilumab: Clinical Findings And Patient-Reported Symptoms

Ocular Surface Disease And Its Impact In Patients Treated With Dupilumab: Clinical Findings And Patient-Reported Symptoms

Published 2025 - 43rd Congress of the ESCRS

Reference: FP11.03 | Type: Free paper | DOI: 10.82333/d386-j279

Authors: Marwa Abdellah* ¹ , Amr Mounir ¹

¹Ophthalmology,Sohag University,Sohag,Egypt

Purpose

Dupilumab is a monoclonal antibody that targets interleukin-4 and interleukin-13, commonly used in the treatment of atopic dermatitis and asthma. While it has shown significant benefits in managing these conditions, its effects on the ocular surface are not well understood. This study aims to evaluate ocular surface changes and symptoms in patients undergoing dupilumab treatment, using objective clinical signs and a patient-reported questionnaire. Understanding these ocular effects is essential for optimizing treatment and managing potential side effects in patients receiving long-term dupilumab therapy.

Setting

Single-center study at ULS São João, Porto, based on pharmacy department records of patients receiving dupilumab.

Methods

A retrospective study was conducted on patients treated with dupilumab for at least six months, followed at ULS São João, Porto, using records from the pharmacy department. Patients who agreed to participate in the presented study were included. Clinical signs were assessed through standardized ocular surface evaluation and subjective symptoms were documented using the Dupilumab-associated Ocular Surface Disease Activity Assessment Questionnaire (DAOSD-AAQ). Patients' demographics, including sex, age, and primary indication for dupilumab were recorded.

Results

Among 36 patients, 19 (52.8%) were male, with a mean age of 44.8 ± 14.0 years. The main indications for dupilumab were atopic eczema (20, 55.6%), severe asthma (8, 22.2%), and nasal polyposis (4, 11.1%). Ocular findings included posterior blepharitis (15, 41.7%), conjunctival hyperemia (18, 50%), and corneal limbal neovascularization (3, 8.3%). Notable complications included ectropion (2, 5.6%) and episcleritis (1, 2.8%). Using DAOSD-AAQ, the most frequently reported symptoms were sensitivity to light (23, 63.9%), blurry vision (23, 63.9%) and itchiness (14, 38.9%). 17 patients (47.2%) needed an ophthalmology emergency visit for surface complaints after starting dupilumab; 14 (82.4%) required ocular medication, but only 8 (57.1%) improved.

Conclusions

Ocular surface disease is a frequent adverse effect in patients treated with dupilumab. Clinical signs do not always align with subjective symptoms, underscoring the need for comprehensive assessment in affected individuals. The high rate of emergency ophthalmology visits and the frequent need for specific treatment highlight the impact of these complications. Early recognition and targeted management strategies may improve patient outcomes.