A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer

Abstract Ocular surface dysfunction is common in patients receiving anti-cancer drug treatment. The effects of paclitaxel, a neurotoxic chemotherapeutic drug, on ocular surface discomfort associated with dry eye disease was investigated. Patients with cancer who had completed paclitaxel treatment be...

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Autores principales:	Jeremy Chung Bo Chiang, David Goldstein, Terry Trinh, Kimberley Au, Susanna B. Park, Arun V. Krishnan, Maria Markoulli
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a14b8869ea1243bfb5a35b0d7d387b4e
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spelling	oai:doaj.org-article:a14b8869ea1243bfb5a35b0d7d387b4e2021-12-02T10:49:29ZA cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer10.1038/s41598-021-81398-y2045-2322https://doaj.org/article/a14b8869ea1243bfb5a35b0d7d387b4e2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81398-yhttps://doaj.org/toc/2045-2322Abstract Ocular surface dysfunction is common in patients receiving anti-cancer drug treatment. The effects of paclitaxel, a neurotoxic chemotherapeutic drug, on ocular surface discomfort associated with dry eye disease was investigated. Patients with cancer who had completed paclitaxel treatment between 3 and 24 months prior to assessment (n = 29) and age- and sex-matched healthy control subjects (n = 29) were recruited and assessed with the Ocular Surface Disease Index (OSDI) to measure ocular surface discomfort. In-vivo corneal confocal microscopy was used to evaluate corneal nerve parameters in the right eye. Peripheral neurotoxicity was assessed using patient-reported outcomes and clinical grading scales. The paclitaxel group had significantly worse OSDI total scores compared with controls (Median, Md = 19.3 and Md = 0, p = 0.007, respectively). Corneal nerve fiber and inferior whorl lengths were reduced in the paclitaxel group compared with controls (14.2 ± 4.0 and 14.4 ± 4.0 mm/mm2 vs. 16.4 ± 4.0 and 16.9 ± 4.9 mm/mm2, respectively, p = 0.04). When analyzed by presence of peripheral neuropathy, paclitaxel-treated patients with neuropathy showed worse OSDI total scores compared to those without peripheral neuropathy post-treatment (p = 0.001) and healthy controls (p < 0.001). More severe ocular discomfort and worse visual function was associated with greater peripheral neurotoxicity symptoms (r = 0.60, p = 0.001) and neuropathy severity (r = 0.49, p = 0.008), respectively. Patients who have been treated with paclitaxel have a higher risk of ocular surface discomfort associated with dry eye disease, particularly those with peripheral neuropathy. Future longitudinal studies should investigate the clinical impact of corneal nerve reduction in dry eye disease.Jeremy Chung Bo ChiangDavid GoldsteinTerry TrinhKimberley AuSusanna B. ParkArun V. KrishnanMaria MarkoulliNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jeremy Chung Bo Chiang David Goldstein Terry Trinh Kimberley Au Susanna B. Park Arun V. Krishnan Maria Markoulli A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
description	Abstract Ocular surface dysfunction is common in patients receiving anti-cancer drug treatment. The effects of paclitaxel, a neurotoxic chemotherapeutic drug, on ocular surface discomfort associated with dry eye disease was investigated. Patients with cancer who had completed paclitaxel treatment between 3 and 24 months prior to assessment (n = 29) and age- and sex-matched healthy control subjects (n = 29) were recruited and assessed with the Ocular Surface Disease Index (OSDI) to measure ocular surface discomfort. In-vivo corneal confocal microscopy was used to evaluate corneal nerve parameters in the right eye. Peripheral neurotoxicity was assessed using patient-reported outcomes and clinical grading scales. The paclitaxel group had significantly worse OSDI total scores compared with controls (Median, Md = 19.3 and Md = 0, p = 0.007, respectively). Corneal nerve fiber and inferior whorl lengths were reduced in the paclitaxel group compared with controls (14.2 ± 4.0 and 14.4 ± 4.0 mm/mm2 vs. 16.4 ± 4.0 and 16.9 ± 4.9 mm/mm2, respectively, p = 0.04). When analyzed by presence of peripheral neuropathy, paclitaxel-treated patients with neuropathy showed worse OSDI total scores compared to those without peripheral neuropathy post-treatment (p = 0.001) and healthy controls (p < 0.001). More severe ocular discomfort and worse visual function was associated with greater peripheral neurotoxicity symptoms (r = 0.60, p = 0.001) and neuropathy severity (r = 0.49, p = 0.008), respectively. Patients who have been treated with paclitaxel have a higher risk of ocular surface discomfort associated with dry eye disease, particularly those with peripheral neuropathy. Future longitudinal studies should investigate the clinical impact of corneal nerve reduction in dry eye disease.
format	article
author	Jeremy Chung Bo Chiang David Goldstein Terry Trinh Kimberley Au Susanna B. Park Arun V. Krishnan Maria Markoulli
author_facet	Jeremy Chung Bo Chiang David Goldstein Terry Trinh Kimberley Au Susanna B. Park Arun V. Krishnan Maria Markoulli
author_sort	Jeremy Chung Bo Chiang
title	A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
title_short	A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
title_full	A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
title_fullStr	A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
title_full_unstemmed	A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
title_sort	cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a14b8869ea1243bfb5a35b0d7d387b4e
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A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer

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