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Table 1 Symptoms, clinical signs, and in vivo confocal microscopy of the cornea in the worst eye of a patient treated with belantamab mafodotin

From: Corneal in vivo confocal microscopy to detect belantamab mafodotin-induced ocular toxicity early and adjust the dose accordingly: a case report

Time (weeks)

Pre-

3

6

9

12

15

36

Symptoms, vision, and slit-lamp examination of the cornea

       

Blurred vision (CTCAE, 0–4)

0

0

3*

0

1

1

0

Photophobia (CTCAE, 0–4)

0

1

2

0

0

0

0

Visual acuity

20/20

20/20

20/40*

20/20

20/25

20/25

20/20

SPK (0–5)

0

1

3*

2

2

2

0

Microcysts

None

None

Diffuse

Diffuse

Diffuse

Diffuse

None

In vivo confocal microscopy of the cornea. Location: peripheral/central

       

Epithelial microcysts

       

 Density (/mm2)

  

25/6.3

6.3/12.5

0/6.3

62.5/62.5

0/0

 Average size (μm)

0/0

0/0

10.7/14.3

18.4/14.7

0/14.7

18.8/15.7

 

 Circularity (0–1)

  

0.67/0.9

0.88/0.94

/0.94

0.77/0.84

 

Hyperreflective deposits: superficial epithelium

       

 Density (/μm2)

 

31.3§/0

138/87.5

62.5/81.3

56.3/62.3

62.5/106

 

 Average size (μm)

0/0

8.5/na

6.8/7.5

7.1/9.1

7.6/7.4

8.8/9

0/0

 Circularity (0–1)

 

0.72/na

0.67/0.69

0.72/0.80

0.62/0.65

0.81/0.83

 

Hyperreflective deposits: basal epithelium

       

 Density (/μm2)

 

68.8§/0

381/219

343/119

131/93.8

93.8/206

 

 Average size (μm)

0/0

9.0/na

9.9/8.9

6.9/9.1

8.6/7.2

8.7/9.2

0/0

 Circularity (0–1)

 

0.56/na

0.61/0.64

0.75/0.75

0.63/0.59

0.67/0.74

 

Hyperreflective deposits: sub-Bowman nerve plexus layer (anterior stroma)

       

 Density (/μm2)

 

100§/0

225/169

62.5/50

37.5/68.8

75/31.3

 

 Average size (μm)

0/0

6.4/na

8.2/8.9

8/6.3

7.5/6.4

6.6/7.9

0/0

 Circularity (0–1)

 

0.66/na

0.61/0.64

0.48/0.64

0.64/0.72

0.69/0.59

 

Treatment (belantamab mafodotin)

       

Delivered dose after exams (mg/kg)

2.5

2.5

0

1.9

1.9

0

0

Cumulative dose (mg)

0

180

360

360

490

620

620

  1. CTCAE common terminology criteria for adverse events, na not applicable, SPK superficial punctuate keratitis. (Oxford’s score)
  2. *Clinical ocular features that influenced the dose adjustment/temporary discontinuation of belantamab mafodotin
  3. §IVCM putative preclinical markers for ocular toxicity (before any clinical signs/symptoms)