akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2025.661akusherstvo-2521Research ArticleREVIEW ARTICLEНАУЧНЫЙ ОБЗОРVisual impairments associated with the treatment of malignant tumors of the female reproductive system: a literature review and practical recommendations for oncogynecologistsЗрительные нарушения при лечении злокачественных новообразований женской репродуктивной системы: обзор литературы и практические рекомендации для онкогинекологовhttps://orcid.org/0009-0008-3694-902XЧуйковаЕ. А.ChuikovaY. A.

Чуйкова Елизавета Андреевна

44281 Кфар-Саба, ул. Черниховски, д. 59

Yelyzaveta A. Chuikova, MD

59 Tchernichovsky Str., Kfar Saba 44281

cujkovae01@gmail.comhttps://orcid.org/0009-0006-1993-2029ОдинцоваО. А.OdintsovaO. A.

Одинцова Ольга Александровна

350063, Краснодар, ул. Митрофана Седина, д. 4

Olga A. Odintsova

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0007-4741-7822СкалозубД. В.SkalozubD. V.

Скалозуб Дмитрий Владимирович

Митрофана Седина, д. 4

Dmitriy V. Skalozub

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0005-7424-5750АнтонюкА. Г.AntonyukA. G.

Антонюк Артём Григорьевич

350063, Краснодар, ул. Митрофана Седина, д. 4

Artem G. Antonyuk

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0004-1934-3406КабартайА. А.KabartaiA. A.

Кабартай Анзор Ассад

360004 Нальчик, ул. Чернышевского, д. 173

Anzor A. Kabartai

173 Chernyshevsky Str., Nalchik 360004

https://orcid.org/0009-0001-0804-3238НурмаматоваА. Н.NurmamatovaA. N.

Нурмаматова Азема Нурмаматовна

117513 Москва, ул. Островитянова, д. 1

Azema N. Nurmamatova

1 Ostrovityanova Str., Moscow 117513

https://orcid.org/0009-0009-1817-5873АзимовР. М.AzimovR. M.

Азимов Расим Мейхошиевич

117513 Москва, ул. Островитянова, д. 1

Rasim M. Azimov

1 Ostrovityanova Str., Moscow 117513

https://orcid.org/0009-0005-5630-8316СнатенковаП. А.SnatenkovaP. A.

Снатенкова Полина Андреевна

117513 Москва, ул. Островитянова, д. 1

Polina A. Snatenkova

1 Ostrovityanova Str., Moscow 117513

https://orcid.org/0009-0006-3717-8058СилантьевА. А.SilantyevA. A.

Силантьев Алексей Александрович

117513 Москва, ул. Островитянова, д. 1

Aleksey A. Silantyev

1 Ostrovityanova Str., Moscow 117513

https://orcid.org/0009-0007-3810-6926ОсинаС. Р.OsinaS. R.

Осина Софья Романовна

117513 Москва, ул. Островитянова, д. 1

Sofya R. Osina

1 Ostrovityanova Str., Moscow 117513

https://orcid.org/0009-0005-1835-7715МинасянД. С.MinasyanD. S.

Минасян Давид Суренович

350063, Краснодар, ул. Митрофана Седина, д. 4

David S. Minasyan

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0001-6595-8522ЛашевичС. А.LashevichS. A.

Лашевич Софья Андреевна

350063, Краснодар, ул. Митрофана Седина, д. 4

Sofya A. Lashevich

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0007-2522-1255ИсаеваИ. А.IsaevaI. A.

Исаева Инна Алексеевна

350063, Краснодар, ул. Митрофана Седина, д. 4

Inna A. Isaeva

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0009-0009-0508-8551РухлядьеваЕ. А.RukhlyadyevaE. A.

Рухлядьева Екатерина Александровна

610027 Киров, ул. Карла Маркса, д. 112

Ekaterina A. Rukhlyadyeva

112 Karl Marx Str., Kirov 610027

Медицинский центр «Меир»ИзраильMeir Medical Center, Clalit Health ServicesIsraelФГБОУ ВО «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKuban State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Кабардино-Балкарский государственный университет имени Х.М. Бербекова»РоссияBerbekov Kabardino-Balkarian State UniversityRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова (Пироговский Университет)» Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University (Pirogov Uuniversity), Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Кировский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKirov State Medical University, Ministry of Health of the Russian FederationRussian Federation20200108202500Online First2521Copyright © Chuikova Y.A., Odintsova O.A., Skalozub D.V., Antonyuk A.G., Kabartai A.A., Nurmamatova A.N., Azimov R.M., Snatenkova P.A., Silantyev A.A., Osina S.R., Minasyan D.S., Lashevich S.A., Isaeva I.A., Rukhlyadyeva E.A., 20202020Чуйкова Е.А., Одинцова О.А., Скалозуб Д.В., Антонюк А.Г., Кабартай А.А., Нурмаматова А.Н., Азимов Р.М., Снатенкова П.А., Силантьев А.А., Осина С.Р., Минасян Д.С., Лашевич С.А., Исаева И.А., Рухлядьева Е.А.Chuikova Y.A., Odintsova O.A., Skalozub D.V., Antonyuk A.G., Kabartai A.A., Nurmamatova A.N., Azimov R.M., Snatenkova P.A., Silantyev A.A., Osina S.R., Minasyan D.S., Lashevich S.A., Isaeva I.A., Rukhlyadyeva E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2521

Ophthalmictoxicity has become increasingly relevant upon introduction of novel anticancer agents – targeted therapies, immunotherapies, and endocrine treatments. Women with malignancies of the reproductive system, including ovarian, endometrial, and cervical cancers have been receiving treatments associated with potential visual impairments more frequently. This review consolidates the data on ocular adverse events associated with key drug classes used in gynecologic oncology: BRAF (B-Raf proto-oncogene, serine/threonine kinase) inhibitors, MEK inhibitors (mitogen-activated protein kinase kinase) inhibitors, immune checkpoint inhibitors (ICIs), including PD-1 (programmed cell death protein 1), PD-L1 (programmed cell death-ligand 1), and CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), antiangiogenic agents targeting VEGF (vascular endothelial growth factor) and VEGFR (vascular endothelial growth factor receptor), as well as selective estrogen receptor modulators (SERMs), aromatase inhibitors, and PARP (poly(ADP-ribose) polymerase) inhibitors. Particular attention is paid to the most common and clinically significant toxicities, including uveitis, keratitis, dry eye syndrome, macular edema, retinopathy, optic neuritis, and rarer but severe complications such as retinal vein occlusion and retinal detachment. In addition, it also presents differentiated approaches to diagnosing and managing ophthalmic toxicity related to the specific drug class. The importance of multidisciplinary collaboration between oncologists, gynecologists, and ophthalmologists is emphasized to ensure timely identification and management of visual impairments. Practical recommendations are provided for screening, monitoring, and managing patients at risk of ocular complications, including referral algorithms and treatment modification strategies. The article aims to increase awareness among gynecologic oncologists regarding ocular toxicity and optimize the clinical management of affected patients.

С внедрением в клиническую практику новых противоопухолевых агентов – таргетной терапии, иммунотерапии, эндокринных препаратов офтальмологическая токсичность приобретает все большее значение. Женщины с опухолями репродуктивной системы, включая рак яичников, эндометрия и шейки матки, все чаще получают терапию, ассоциированную с потенциальными зрительными нарушениями. В настоящем обзоре систематизированы данные о глазных побочных эффектах, связанных с основными классами противоопухолевых средств, применяемых в онкогинекологии: ингибиторами BRAF (англ. B-Rafproto-oncogene, serine/threoninekinase; прототоонкоген B-раф, серин/треонин-киназа), MEK (англ. mitogen-activated protein kinase kinase; митоген-активируемая протеинкиназа киназа), ингибиторами иммунных контрольных точек (англ. immune check point inhibitors; ICIs), включая PD-1 (англ. programmed cell death protein 1; белок программируемой клеточной гибели 1), PD-L1 (англ. programmed cell death-ligand 1; лиганд программируемой клеточной гибели 1), CTLA-4 (англ. cytotoxic T-lymphocyte-associated protein 4; цитотоксический антиген-4 Т-лимфоцитов), антиангиогенными средствами, воздействующими на VEGF (англ. vascular endothelial growth factor; фактор роста эндотелия сосудов) и VEGFR (англ. vascular endothelial growth factor receptor; рецептор фактора роста эндотелия сосудов), а также с использованием SERM (англ. selective estrogen receptor modulators; селективные модуляторы рецепторов эстрогена), ингибиторов ароматазы и PARP (англ. poly(ADP-ribose) polymerase; поли(АДФ-рибоза)полимераза)-ингибиторов. Особое внимание уделено наиболее распространенным и клинически значимым нарушениям, таким как увеит, кератит, синдром сухого глаза, макулярный отек, ретинопатия, неврит зрительного нерва, а также редким, но тяжелым осложнениям, включая окклюзию вен сетчатки и отслойку сетчатки. Представлены дифференцированные подходы к диагностике и ведению офтальмотоксичности в зависимости от конкретного класса препаратов. Подчеркнута необходимость междисциплинарного взаимодействия между онкологом, акушером-гинекологом и офтальмологом для своевременного выявления и коррекции зрительных нарушений. Предложены практические рекомендации по скринингу, мониторингу и ведению пациенток с риском офтальмологических осложнений. Статья направлена на повышение осведомленности онкогинекологов о значении офтальмотоксичности и оптимизацию клинического маршрута пациенток.

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The authors declare that there are no conflicts of interest present.