Knowing the Flip Side of the Coin: Ibrutinib Associated Cystoid Macular Edema

  • Sumeet P. MirghEmail author
  • Rayaz Ahmed
  • Narendra Agrawal
  • Sneha Bothra
  • Bhaarat Mohan
  • Ambar Garg
  • Shinto Francis Thekkudan
  • Vishvdeep Khushoo
  • Dinesh Bhurani

Dear Editor,

A 62-year-old man, normotensive, non-diabetic, was diagnosed with CLL in October 2009, Rai stage 3, Binet stage B. He was treated initially with chlorambucil monotherapy for 12 months due to symptomatic massive splenomegaly and achieved a partial response. In 2012, he received 6 cycles of Bendamustine–Rituximab (BR) chemoimmunotherapy and achieved a partial response. After 18 months, he presented with a second relapse. Molecular studies (FISH–CLL panel) revealed both 11q and 13q deletion. Patient was initiated on Ibrutinib (Imbruvica) monotherapy. Initially, he tolerated ibrutinib well and achieved a partial response. Due to recurrent sino-nasal infections and low IgG levels (IgG, 203 mg/dl), he received intravenous immunoglobulin 0.4 g/kg monthly for 6 months. After 4 years on ibrutinib, (September 2018), he reported visual blurring, with intermittent flashes of light in both eyes for the previous 1 year. Due to these symptoms, he underwent a left eye cataract surgery;...


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Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  1. 1.Department of HematologyRajiv Gandhi Cancer InstituteNew DelhiIndia
  2. 2.Parel, MumbaiIndia

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