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Case Report
An ocular twist to cancer therapy: Pseudomicrocysts and myopic shift linked to trastuzumab emtansine
1 21A Elliott Crescent, Havelock North, Hawkes Bay 4130, New Zealand
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Felix Henry Bird
21A Elliott Crescent, Havelock North, Hawkes Bay 4130,
New Zealand
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Article ID: 100046Z17FB2025
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How to cite this article
Bird FH, Sahoo B, Oskam J. An ocular twist to cancer therapy: Pseudomicrocysts and myopic shift linked to trastuzumab emtansine. J Case Rep Images Opthalmol 2025;8(2):1–4.ABSTRACT
A 49-year-old woman with a diagnosis of HER-2 positive breast cancer on trastuzumab emtansine (Kadcyla) therapy developed symptoms of dry eye, and blurry vision bilaterally. Subjective myopic shift was noted and slit lamp examination revealed bilateral corneal epithelial pseudomicrocysts. These ocular symptoms emerged within weeks of Kadcyla initiation, improved with drug cessation and recurred on reintroduction, suggestive of keratopathy secondary to antibody-drug conjugate (ADC) toxicity. Management included intensive ocular lubrication, close follow-up, and reassurance of the temporality of symptoms with ADC use. Antibody-drug conjugate therapy was continued as tolerated. This case highlights the potential for reversible keratopathy, including pseudomicrocysts and myopic shift associated with trastuzumab emtansine.
Keywords: Antibody-drug conjugate, Corneal pseudomicrocysts, Myopic shift, Trastuzumab emtansine
SUPPORTING INFORMATION
Author Contributions
Felix Henry Bird - Substantial contributions to conception and design, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Baswati Sahoo - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Joshua Oskam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Felix Henry Bird et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
