Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves
Abstract Introduction This prospective case series investigated corneal epithelial and subbasal nerve plexus changes associated with belantamab mafodotin (Belamaf) therapy in patients with refractory/relapsed multiple myeloma using a multimodal imaging approach. Methods We included eight patients (m...
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Adis, Springer Healthcare
2025-05-01
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| Series: | Ophthalmology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40123-025-01147-6 |
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| author | Jakob Schweighofer Hermine Agis Maria Krauth Ruth Donner Marion Funk Jan Lammer Michal Klimek Gerald Schmidinger Julia Aschauer |
| author_facet | Jakob Schweighofer Hermine Agis Maria Krauth Ruth Donner Marion Funk Jan Lammer Michal Klimek Gerald Schmidinger Julia Aschauer |
| author_sort | Jakob Schweighofer |
| collection | DOAJ |
| description | Abstract Introduction This prospective case series investigated corneal epithelial and subbasal nerve plexus changes associated with belantamab mafodotin (Belamaf) therapy in patients with refractory/relapsed multiple myeloma using a multimodal imaging approach. Methods We included eight patients (mean age 66 ± 10) scheduled for Belamaf who were monitored for at least three treatment cycles. Standard clinical eye exams with Snellen best corrected visual acuity (BCVA) measurements were complemented by epithelial thickness mapping, slit lamp photography, corneal sensitivity testing, and corneal confocal microscopy. Results The mean drop in BCVA was limited to 1 line (20/25 to 20/32) with mean loss in sensitivity from 5.2 ± 0.4 to 8.7 ± 3.4 mg/S. Corneal epithelial thickness increased (from a mean of 62 ± 4.7 to 74 ± 6.2 μm) presenting an irregular pattern from the apex to the mid-periphery. All patients developed microcystic epithelial changes and ocular surface disease. Confocal microscopy revealed a decrease in mean nerve fiber length and density from 12.46 ± 4.94 mm/mm2 and 21.87 ± 10.27/mm2 at baseline to 3.27 ± 3.9 mm/mm2 and 1.78 ± 3.22/mm2 at last follow-up, respectively, with preserved limbal architecture. Conclusion This prospective study confirms and further characterizes the pathognomonic epithelial changes caused by Belamaf, which are accompanied by severe impairment in subbasal nerve fiber architecture, indicating a neurotoxic effect of the medication that requires further investigation. |
| format | Article |
| id | doaj-art-45a67b8121cb4beebdf4879352cc753b |
| institution | DOAJ |
| issn | 2193-8245 2193-6528 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Adis, Springer Healthcare |
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| series | Ophthalmology and Therapy |
| spelling | doaj-art-45a67b8121cb4beebdf4879352cc753b2025-08-20T03:21:02ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-05-011471453146410.1007/s40123-025-01147-6Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal NervesJakob Schweighofer0Hermine Agis1Maria Krauth2Ruth Donner3Marion Funk4Jan Lammer5Michal Klimek6Gerald Schmidinger7Julia Aschauer8Department of Ophthalmology and Optometry, Medical University of ViennaClinical Division of Hematology and Hemostaseology (H.A.), Department of Internal Medicine I, Medical University of ViennaClinical Division of Hematology and Hemostaseology (H.A.), Department of Internal Medicine I, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaDepartment of Ophthalmology and Optometry, Medical University of ViennaAbstract Introduction This prospective case series investigated corneal epithelial and subbasal nerve plexus changes associated with belantamab mafodotin (Belamaf) therapy in patients with refractory/relapsed multiple myeloma using a multimodal imaging approach. Methods We included eight patients (mean age 66 ± 10) scheduled for Belamaf who were monitored for at least three treatment cycles. Standard clinical eye exams with Snellen best corrected visual acuity (BCVA) measurements were complemented by epithelial thickness mapping, slit lamp photography, corneal sensitivity testing, and corneal confocal microscopy. Results The mean drop in BCVA was limited to 1 line (20/25 to 20/32) with mean loss in sensitivity from 5.2 ± 0.4 to 8.7 ± 3.4 mg/S. Corneal epithelial thickness increased (from a mean of 62 ± 4.7 to 74 ± 6.2 μm) presenting an irregular pattern from the apex to the mid-periphery. All patients developed microcystic epithelial changes and ocular surface disease. Confocal microscopy revealed a decrease in mean nerve fiber length and density from 12.46 ± 4.94 mm/mm2 and 21.87 ± 10.27/mm2 at baseline to 3.27 ± 3.9 mm/mm2 and 1.78 ± 3.22/mm2 at last follow-up, respectively, with preserved limbal architecture. Conclusion This prospective study confirms and further characterizes the pathognomonic epithelial changes caused by Belamaf, which are accompanied by severe impairment in subbasal nerve fiber architecture, indicating a neurotoxic effect of the medication that requires further investigation.https://doi.org/10.1007/s40123-025-01147-6BelamafBelantamab mafodotinCorneal nervesConfocal microscopySubbasal nerve fiber changes |
| spellingShingle | Jakob Schweighofer Hermine Agis Maria Krauth Ruth Donner Marion Funk Jan Lammer Michal Klimek Gerald Schmidinger Julia Aschauer Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves Ophthalmology and Therapy Belamaf Belantamab mafodotin Corneal nerves Confocal microscopy Subbasal nerve fiber changes |
| title | Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves |
| title_full | Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves |
| title_fullStr | Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves |
| title_full_unstemmed | Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves |
| title_short | Corneal Findings in Patients Treated with Belantamab Mafodotin: A Prospective Case Series Focusing on Corneal Nerves |
| title_sort | corneal findings in patients treated with belantamab mafodotin a prospective case series focusing on corneal nerves |
| topic | Belamaf Belantamab mafodotin Corneal nerves Confocal microscopy Subbasal nerve fiber changes |
| url | https://doi.org/10.1007/s40123-025-01147-6 |
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