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Retinal Physician

Article

Standardizing Ocular Toxicity Grading for ADCs

Updated, anatomically specific scales aim to improve consistency in assessing ocular adverse events and guide dose modification in oncology trials. Physicians say their use in the real world remains variable.

Sarah Fackler, managing editor, Optometric Management
Retinal Physician February 1, 2026
5 Key Takeaways

  • 1

    Anatomically specific ocular toxicity grading scales improve consistency in assessing ocular adverse events from antibody-drug conjugates (ADCs).

  • 2

    The new grading scales separate objective signs from subjective symptoms and provide explicit recommendations for dose modification.

  • 3

    Corneal pseudomicrocysts, common in ADC patients, were excluded from grading due to their potential asymptomatic nature and difficulty in visualization.

  • 4

    The consensus group developed a grading system that has shown high agreement among ophthalmologists and oncologists, improving patient management.

  • 5

    Despite their effectiveness in clinical trials, real-world application of the new scales remains variable among physicians treating ADC-related ocular toxicity.