Intravitreal Steroid Treatment for Uveitis Associated with Dabrafenib and Trametinib for Metastatic Cutaneous Melanoma

Ocul Immunol Inflamm. 2021 Jul 4;29(5):845-847. doi: 10.1080/09273948.2019.1695860. Epub 2020 Jan 6.

Abstract

Purpose: To report a case of bilateral retinal inflammation under long-term therapy with dabrafenib/trametinib for metastatic cutaneous melanoma.Methods: Retrospective chart review.Results: A 59-year-old patient with metastatic cutaneous melanoma diagnosed in 2004 under treatment with dabrafenib/trametinib since 2014 presented to our department with intraretinal hemorrhage and extrafoveal macula edema on the right eye and optic disc swelling on the left eye. The patient did not report visual complaints. After cessation of dabrafenib/trametinib and subconjunctival and intravitreal corticosteroid injections, optic disc swelling on the left eye recovered after 6 months. The macula edema on the right eye was treated with one intravitreal anti-VEGF (vascular endothelial growth factor) injection after encroaching upon the fovea 10 months after initial presentation. The final visual acuity was 20/20 on both eyes.Conclusion: Even after years of treatment with low dose dabrafenib/trametinib, ocular toxicity can develop. Such cases can respond well to intravitreal corticosteroids.

Keywords: BRAF inhibitor; MEK inhibitor; Uveitis; melanoma; ocular toxicity.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Coloring Agents / administration & dosage
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use*
  • Humans
  • Imidazoles / administration & dosage
  • Indocyanine Green / administration & dosage
  • Intravitreal Injections
  • Macular Edema / chemically induced
  • Macular Edema / drug therapy
  • Macular Edema / physiopathology
  • Melanoma / drug therapy*
  • Melanoma, Cutaneous Malignant
  • Oximes / administration & dosage
  • Papilledema / chemically induced
  • Papilledema / drug therapy
  • Papilledema / physiopathology
  • Pyridones / administration & dosage
  • Pyrimidinones / administration & dosage
  • Retrospective Studies
  • Skin Neoplasms / drug therapy*
  • Triamcinolone Acetonide / therapeutic use
  • Uveitis / chemically induced
  • Uveitis / drug therapy*
  • Uveitis / physiopathology
  • Visual Acuity / physiology

Substances

  • Coloring Agents
  • Glucocorticoids
  • Imidazoles
  • Oximes
  • Pyridones
  • Pyrimidinones
  • trametinib
  • Triamcinolone Acetonide
  • Indocyanine Green
  • dabrafenib