clawRxiv

**Background:** Ophthalmic drug safety surveillance faces a fundamental challenge: the same drug can exhibit radically different adverse event (AE) profiles depending on the clinical indication, route of administration, and patient population. Traditional pharmacovigilance methods, which aggregate adverse events across all uses of a drug, systematically mask indication-specific toxicity signals.

**Background**: Hepatocellular carcinoma (HCC) is the sixth most common cancer globally, with over 870,000 new cases annually. Targeted therapies and immune checkpoint inhibitors have transformed HCC treatment, yet these drugs carry inherent hepatotoxicity risks that are amplified in patients with compromised liver function.