Barzilai University Medical Center

122 Research Day 2020 Barzilai University Medical Center 88 OPTIC DISC EDEMA AND RETINAL ABNORMALITY SECONDARY TO DASATINIB TREATMENT IN A PATIENT WITH CHRONIC MYELOID LEUKEMIA. Reut Singer 1 , Anatoly, Nemets 2 , Eyal Aloni 1 , Barzilai University Medical Center, 2 Department Hematology , 1 Ophthalmology Department Ashkelon Faculty of Sciences, Ben Gurion University of the Negev, Israel Background Dasatinib (Sprysel) is a new second generation oral Bcr-Abl tyrosine kinase inhibitor, approved for first line treatment of patients wit h chronic myelogenous leukemia ( CML). According to phase 1 and 2 studies published to date ophthalmological secondary effects of dasatinib, are practically non-existent or trivial. Resent literature case report suggest the possibility of secondary optic neuropathy caused by the drug. Methods We present ophthalmic manifestations of a 46 years-old female who was recently diagnosed with CML and started on dasatinib treatment. Results Two and a half months after beginning treatment with Dasatinib, the patient started complaining of photopsias in both eyes, exuberated by high pitch sound, and of blurred vision in her inferior visual field of her left eye. On examination the patient had bilateral severe swollen disc with normal sensory and motor visual functions except for a Humphrey visual field showing enlargement of the blind spot in both eyes and a left eye inferior arcuate defect. She underwent extensive complementary tests that ruled out infectious, inflammatory and infiltrative disorders and IIH, following which she was suspected of optic neuropathy secondary to Dasatinib treatment. Dasatinib treatment was stopped and treatment with oral prednisone was started with improvement of her symptoms and resolution of the swollen discs. Full field ERG showed slight to moderate depression of the b wave in the left eye while VEP was normal in both eyes. Conclusion To our best knowledge, this is the second case report in the literature describing optic nerve swelling relate to Dasatinid treatment and the first to show retinal toxicity as seen on ERG. Physicians treating patients with Dasatinid should be aware of the possibility of severe ophthalmic toxicity related to the drug.