Dupilumab-associated ocular manifestations: A review of clinical presentations and management

Proposed management algorithm for dupilumab‐associated ocular side effects: a collaborative effort between dermatologists and ophthalmologists

“…Firstly, the manifestations of DOSE extend beyond the ocular surfaceintraocular inflammation in the form of uveitis, scleritis and cystoid macular oedema, as well as periocular involvement in the form of dermatitis and punctal stenosis have been reported in previous case studies. 2 Although no causal relationship was identified between the development of these complications and dupilumab usage, rarer complications such as intraocular inflammation only manifested 7-24 months after the initiation of dupilumab, supporting the need for follow-up studies of longer duration among patients utilizing dupilumab. 3 Secondly, the authors presented a few prominent hypotheses surrounding its pathogenesis.…”

“…1 We have recently conducted a collaborative review involving dermatologists and ophthalmologists on dupilumab-associated ocular side effects (DOSE), in which we presented a management algorithm for the various ocular manifestations. 2 Owing to the controversy surrounding the pathomechanisms behind dupilumab's side effects, our group proposes usage of the term 'dupilumab-associated ocular side effects' to more accurately represent the nature of this entity. We would like to take this opportunity to add a few pertinent points to the review by Neagu et al concerning the presentation, pathogenesis and management of this unique disease entity.…”

“…We have proposed a management algorithm to treat the various manifestations of DOSE following extensive review of prevailing literature. 2 This set of recommendations represents a joint consensus by ophthalmologists and dermatologists on the optimal management of DOSE. In particular, we also recommend a baseline ophthalmological examination, patch testing and regular surveillance of patients receiving dupilumab when possible, to identify and treat DOSE in a timely manner.…”

Dupilumab‐associated ocular surface disease in atopic dermatitis patients: Clinical characteristics, ophthalmic treatment response and conjunctival goblet cell analysis

“…DAOSD in AD patients can be severe and persistent, with potentially irreversible consequences in case of chronic limbal inflammation and may lead to discontinuation of treatment with dupilumab 5,6 . Several treatment options for DAOSD have been described in small case reports and case series, including artificial tears, antihistaminic eye drops, tacrolimus skin ointment and corticosteroid eye drops 7–9 . However, there is no official guideline for the treatment of DAOSD, and knowledge about the effect of ophthalmic treatment is needed 8,9 …”

“…5,6 Several treatment options for DAOSD have been described in small case reports and case series, including artificial tears, antihistaminic eye drops, tacrolimus skin ointment and corticosteroid eye drops. [7][8][9] However, there is no official guideline for the treatment of DAOSD, and knowledge about the effect of ophthalmic treatment is needed. 8,9 We previously examined conjunctival biopsies of AD patients with DAOSD and found focal scarcity of intraepithelial goblet cells (GCs).…”