Dry eye syndrome in aromatase inhibitor users

• Published in: Clinical & experimental ophthalmology 2013-04, Vol.41 (3), p.239-243
• Main Authors: Turaka, Kiran, Nottage, Jennifer M, Hammersmith, Kristin M, Nagra, Parveen K, Rapuano, Christopher J
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; anastrazole; Androstadienes - adverse effects; Antineoplastic Agents, Hormonal - adverse effects; aromasin; aromatase inhibitor; Aromatase Inhibitors - adverse effects; blepharitis; Blepharitis - chemically induced; Blepharitis - diagnosis; Breast Neoplasms - drug therapy; Conjunctival Diseases - chemically induced; Conjunctival Diseases - diagnosis; dry eye syndrome; Dry Eye Syndromes - chemically induced; Dry Eye Syndromes - diagnosis; Female; Humans; Keratitis - chemically induced; Keratitis - diagnosis; Middle Aged; Nitriles - adverse effects; Ovarian Neoplasms - drug therapy; Retrospective Studies; Triazoles - adverse effects; Vision Disorders - chemically induced; Vision Disorders - diagnosis
• ISSN: 1442-6404; 1442-9071
• DOI: 10.1111/j.1442-9071.2012.02865.x

Background Aromatase inhibitors are frequently used as an adjuvant therapy in the treatment of breast cancer. We observed that several patients taking aromatase inhibitors presented with severe dry eye symptoms, and we investigated whether there is a relationship between aromatase inhibitors and dry eyes in these patients. Design Retrospective chart review. Participants Forty‐one women. Methods A computerized search of health records was performed to identify patients using anastrazole, letrozole and exemestane seen by the Cornea Service from August 2008 to March 2011. The results were compared with age‐matched controls. Main Outcome Measures Ocular surface changes among aromatase inhibitors users. Results Of the 41 women, 39 were Caucasians. Thirty‐nine patients had breast cancer (95%), one patient had ovarian cancer (2.5%) and one had an unknown primary cancer. Mean age was 68 ± 11.3 years (range 47–95). Most common presenting symptoms were blurred vision in 28 (68%) patients, irritation/foreign body sensation in 12 (29%) patients, redness in 9 (22%) patients, tearing in 6 (22%) patients and photosensitivity in 2 (5%) patients. Mean Schirmer's test measurement was 11 ± 5.8 mm (range 0.5–20 mm). Blepharitis was noted in 68 of 82 eyes (73%), decreased or poor tear function in 24 eyes (29%), conjunctival injection in 18 eyes (22%) and superficial punctate keratitis in 12 eyes (29%). Among an age‐matched population (45–95 years), dry eye syndrome was found in only 9.5% of patients. Conclusions Because the prevalence of ocular surface disease signs and symptoms appears to be higher in study group than control patients, aromatase inhibitors might be a contributing factor to the dry eye symptoms.