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Blepharitis and Dry eyes in Aromatase Inhibitor Users

Blepharitis and Dry eyes in Aromatase Inhibitor Users. Kiran Turaka, M.D. Kristin M. Hammersmith, M.D. Jennifer M. Nottage, M.D. Christopher J. Rapuano, M.D. Wills Eye Institute, Philadelphia PA The authors have no financial interest in the subject matter of this e-poster. Purpose .

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Blepharitis and Dry eyes in Aromatase Inhibitor Users

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  1. Blepharitis and Dry eyes in Aromatase Inhibitor Users Kiran Turaka, M.D. Kristin M. Hammersmith, M.D. Jennifer M. Nottage, M.D. Christopher J. Rapuano, M.D. Wills Eye Institute, Philadelphia PA The authors have no financial interest in the subject matter of this e-poster

  2. Purpose Anastrazole (Arimidex®) • Aromatase inhibitor (AI), suppress estrogen synthesis from the androgens • Used as an adjuvant therapy in breast/ovarian cancer treatment • Investigation of an association between anastrazoleand dry eye syndrome

  3. Methods • Retrospective chart review • Computerized search of Wills Cornea Service electronic health records between from August 2008 to April 2010. • Results were compared with the age-matched controls from a published study by Schaumberg et al.1 1. Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol 2003; 136:318-26.

  4. Results • Total patients on anastrazole=16 Caucasian women • Breast cancer= 15 (94%) • Ovarian cancer = 1 (6%) • Mean ± SD age was 67 ± 13 years (range 50-95) • Best corrected VA was better than 20/40 in 24 (75%)

  5. Systemic Features

  6. Associated Ocular conditions

  7. Ocular Symptoms • Among the control population (65-69 years), dryness and irritation were found in 5.7% and 0.6% respectively.1

  8. Clinical Features

  9. Slit lamp photograph showing blepharitis and crusts (A), and superficial punctate keratitis (B) on fluorescein staining

  10. Treatment • Tear supplement: 15 patients • Lubricating ointment/gel: 3 patients • Antibiotic ointment: 3 patients • Punctal plugs: 2 patients • Cyclosporine (topical 0.05%): 2 patients • Warm compresses: 2 patients

  11. Summary at the Last follow-up • No. of patients at the follow up = 11 (69%) • No of patients lost to follow up= 5 (31%) • No of patients on Anastrazole = 10 (91%) • Mean ± SD follow-up = 14 ± 7.7 months (range 2-25) • After treatment of dry eyes: • Persistent dry eye symptoms = 3 (27%) • Mild discomfort = 1 (9%) • Best corrected VA was better than 20/40 in 18 (82%) • Tumor status: • Remission of breast cancer = 9 (81%) • Remission of ovarian cancer = 1 (9%) • Systemic metastasis = 1 (9%)

  12. Conclusions • The prevalence of ocular surface disease appears to be higher in the patients taking anastrazole than in age-matched control population1 • Anastrazoleis likely a contributing factor to dry eye symptoms • A larger scale investigation is necessary to evaluate this correlation further

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