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Bilateral corneal infections associated with topical steroid therapy prophylaxis for cytarabine arabinoside-induced keratoconjunctivitis

Leukemia volume 28, pages 220–222 (2014)Cite this article

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Cytarabine arabinoside is a commonly used chemotherapy agent in the treatment of acute myeloid leukemia (AML). One of the reported side effects is cytarabine-associated keratoconjunctivitis, which occurs in up to 40–100% of patients.1 As such, it is exceedingly common for patients to be commenced on prophylactic steroid eye drops. We present a case of bilateral microbial keratitis in a patient commenced on topical steroid prophylaxis for cytarabine-associated keratoconjunctivitis. After resolution of the infection, the patient was left with permanently reduced visual acuity.

On history, she had received three cycles of chemotherapy with cytarabine arabinoside following the diagnosis of AML. On the last cycle she was commenced by her hematologist on g. dexamethasone 0.1% q.i.d. to both eyes (Maxidex, Alcon Laboratories, Frenchs Forrest, NSW, Australia) as prophylaxis against cytarabine-induced keratoconjunctivitis. Five days after cessation of the chemotherapy, her eyes become red and uncomfortable. A small white spot was then noted on the right cornea and she was referred to the eye hospital for review. On admission her white cell count was 14.00 × 109/l, hemoglobin 98 g/l and platelet count 107 × 109/l.

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Authors and Affiliations

  1. Sydney Eye Hospital, Sydney, New South Wales, Australia

    C Samarawickrama, A S Ioannidis, A W Wechsler & S L Watson

  2. University of Sydney, Sydney, New South Wales, Australia

    C Samarawickrama & S L Watson

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  1. C Samarawickrama
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  2. A S Ioannidis
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  3. A W Wechsler
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  4. S L Watson
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Correspondence to C Samarawickrama.

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Samarawickrama, C., Ioannidis, A., Wechsler, A. et al. Bilateral corneal infections associated with topical steroid therapy prophylaxis for cytarabine arabinoside-induced keratoconjunctivitis. Leukemia 28, 220–222 (2014). https://doi.org/10.1038/leu.2013.237

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