Ocular symptoms and signs associated with suramin sodium treatment for metastatic cancer of the prostate

PURPOSE: Therapy with suramin sodium has been associated with photophobia, iritis, optic atrophy, and vortex keratopathy. We studied the ocular findings in patients who underwent treatment with suramin sodium for metastatic cancer of the prostate. METHODS: In a prospective study, 114 patients who underwent treatment with suramin sodium for cancer of the prostate had an ophthalmologic examination within two weeks of onset of treatment and two weeks after termination of therapy. Additional examinations were performed on patients who developed ocular symptoms during suramin sodium therapy. RESULTS: Nineteen (16.6%) of 114 patients developed ocular symptoms and signs while taking suramin sodium. Thirteen of these patients developed bilateral corneal epithelial whorllike deposits, In ten patients, the corneal deposits were associated with foreign body sensation and lacrimation. Symptoms in all of these patients resolved with topical lubricants. Three patients developed asymptomatic corneal deposits. Seven patients had blurred vision and were found to have a mean hyperopic shift in refractive error of 1.13 +/- 0.45 diopters (range, 0.75 to 2.00 diopters) that per sisted throughout their treatment course. None of these patients had a decrease in best corrected visual acuity. CONCLUSIONS: In this study, ocular symptoms and signs associated with suramin sodium were common but were not considered a dose-limiting toxicity, Hyperopic shift in refractive error is a previously unreported ocular finding in association with suramin sodium therapy.