{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:06:01Z","timestamp":1791558361162,"version":"4.3.4"},"reference-count":13,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Mirvetuximab soravtansine (MIRV) improves outcomes in FR\u03b1-positive, platinum-resistant ovarian cancer; however ocular adverse events (OAEs), particularly corneal epithelial toxicity, are frequent and warrant structured ophthalmologic monitoring. Methods: In this retrospective observational study, 31 consecutive patients receiving MIRV for FR\u03b1-positive gynecologic malignancies underwent standardized ophthalmic assessments at baseline and prior to each treatment cycle (every 21 days). The protocol included best corrected visual acuity (BCVA), slit-lamp biomicroscopy, anterior-segment optical coherence tomography (AS-OCT), corneal topography, and tear film analysis. OAEs were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0, based on symptom severity and functional impairment. Results: OAEs occurred in all patients (31\/31, 100%), predominantly grade 1\u20132. Corneal epithelial toxicity was documented in 28\/31 patients (90.3%), while no grade \u2265 3 events were observed. Symptoms typically developed 7\u201314 days after the second infusion. AS-OCT and corneal topography consistently revealed epithelial microcysts and surface irregularities, which were usually detected during scheduled pre-cycle ophthalmologic evaluations. Tear-film instability (break-up time \u2264 5 s) developed in 19\/31 patients (61.3%), generally within 10 days after the second infusion, and improved in all but 2 patients (6.5%) following prophylactic lubrication. Transient refractive changes occurred in 28\/31 patients (90.3%) and were associated with a temporary BCVA reduction (mean nadir ~20\/32 Snellen), followed by recovery during follow-up. Conclusions: MIRV-related ocular alterations are frequent but reversible and clinically manageable. Multimodal imaging combined with functional and refractive assessment provides sensitive markers of corneal epithelial toxicity and supports integrated ophthalmologic monitoring to preserve visual function and maintain oncologic treatment continuity.<\/jats:p>","DOI":"10.3390\/diagnostics16071107","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:09:00Z","timestamp":1775549340000},"page":"1107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Corneal Toxicity of Mirvetuximab Soravtansine: Multimodal Imaging Features and Implications for Ophthalmologic Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3089-7696","authenticated-orcid":false,"given":"Francesco","family":"De Dominicis","sequence":"first","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"IAPB Italia ETS Foundation, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Giudiceandrea","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Cocuzza","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0255-8985","authenticated-orcid":false,"given":"Simone","family":"Bruzio","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Fasciani","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4641-0841","authenticated-orcid":false,"given":"Luigi","family":"Mosca","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Giudiceandrea","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Salgarello","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Epifanio","family":"Giudiceandrea","sequence":"additional","affiliation":[{"name":"San Paolo Hospital, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-8951","authenticated-orcid":false,"given":"Filippo","family":"Amore","sequence":"additional","affiliation":[{"name":"IAPB Italia ETS Foundation, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislao","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Carbone","sequence":"additional","affiliation":[{"name":"Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanda","family":"Salutari","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5579-335X","authenticated-orcid":false,"given":"Anna","family":"Fagotti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Salgarello","sequence":"additional","affiliation":[{"name":"Eye Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/S0140-6736(18)32552-2","article-title":"Epithelial ovarian cancer","volume":"393","author":"Lheureux","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1200\/JCO.19.00194","article-title":"Management of platinum-resistant, relapsed epithelial ovarian cancer and new drug perspectives","volume":"37","author":"Banerjee","year":"2019","journal-title":"J. Clin. 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Cancer Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4426","DOI":"10.1158\/0008-5472.CAN-05-4489","article-title":"Antibody-maytansinoid conjugates are activated in targeted cancer cells by lysosomal degradation and linker-dependent intracellular processing","volume":"66","author":"Erickson","year":"2006","journal-title":"Cancer Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1200\/JCO.2016.69.9538","article-title":"Safety and activity of Mirvetuximab Soravtansine (IMGN853), a folate receptor alpha-targeting antibody-drug conjugate, in platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer: A phase I expansion study","volume":"35","author":"Moore","year":"2017","journal-title":"J. Clin. 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