Erdafitinib-Induced Secondary Maculopathy

J Vitreoretin Dis. 2022 Jun 3;6(4):332-336. doi: 10.1177/24741264221092908. eCollection 2022 Jul-Aug.

Abstract

Purpose: This work presents a case of secondary maculopathy associated with the use of erdafitinib (Balversa) for the management of bladder urothelial carcinoma with bony metastasis.

Methods: A case report is presented.

Results: A 58-year-old Hispanic man presented with blurry vision 3 weeks after starting erdafitinib for the management of bony metastases associated with urothelial carcinoma. A comprehensive evaluation identified multiple areas of subretinal fluid induced by erdafitinib. Throughout treatment, the ocular condition progressed, causing worsening of vision; this led to discontinuation of the drug. Discontinuation was associated with visual and anatomic function improvement.

Conclusions: Fibroblast growth factor receptor (FGFR) plays a major role in maintaining mature and premature retinal pigment epithelium cells. Drugs that inhibit the FGFR pathway block the activation of the mitogen-activated protein kinase pathway, leading to synthesis of antiapoptotic proteins. Erdafitinib is associated with ocular toxicity and leads to multifocal pigment epithelial detachments associated with secondary subretinal fluid.

Keywords: FGFR; MAPK; RPE detachment; central serous chorioretinopathy; erdafitinib; mitogen-activated protein kinase retinopathy; targeted therapy.

Publication types

  • Case Reports