Author: Sofia Anagnostopoulou (Greece)
Co-authors: Nick Liampotis, Dionisis Kalogiros, Maria Tzikanoula, Emilios Zisoulis, Vassiliki Dimera, Eleni Spathi
Purpose
Τo report a case of a bilateral optic neuropathy during melanoma therapy with a combination of Dabrafenib and Trametinib, a B-raf (BRAF) inhibitor and a mitogen/extracellular signal-regulated kinase (MEK) inhibitor, respectively.
Setting/Venue
Ophthalmology Department, General Hospital of Larissa, Larissa, Greece
Methods
This is a case report of a 52-year-old male patient with a history of metastatic cutaneous melanoma under treatment with Dabrafenib/Trametinib who presented to our Department with blurred vision in his right eye and two weeks later in his left eye with no associated eye pain, headache, redness, or floaters. We performed classic ophthalmic evaluation, optical coherence tomography (OCT), Visual Field test, Magnetic Resonance Imaging (MRI) and blood tests to evaluate the case.
Results
His best corrected visual acuity (BCVA) was 10/10 bilaterally. Color testing, slit lamp examination and intraocular pressure (IOP) measurements were normal. Fundus and optical coherence tomography (OCT) examination revealed asymmetric optic disc swelling in both eyes, worse in his left eye. Visual field test showed bilateral blind spot enlargement and an inferior arcuate scotoma. There were no signs of anterior/posterior uveitis in both eyes. Neuroimaging showed no signs of metastasis or increased intracranial pressure and neurological testing was normal. Blood test results were normal and not indicative of infections. The combined treatment was temporarily ceased and the patient was commenced on a new immune targeted agent by his therapist. He gradually reported better visual acuity but the visual field test showed no improvement.
Conlusions
This case report describes the case of bilateral optic disc edema as a possible ocular toxic effect of a combined therapy with Dabrafenib and Trametinib. Due to the increasing use of these drugs and the potential for visual complications, recognition and consideration of the implicative pathophysiology is important.
Financial Disclosure
NONE
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