Uveitis and serous retinal detachment secondary to systemic dabrafenib and trametinib

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2018-09, Vol.93 (9), p.458-462
• Main Authors: Rueda-Rueda, T., Sánchez-Vicente, J.L., Moruno-Rodríguez, A., Molina-Socola, F.E., Martínez-Borrego, A.C., López-Herrero, F.
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Azetidines - administration & dosage; Azetidines - adverse effects; Dabrafenib; Desprendimiento seroso de retina; Drug Synergism; Fatal Outcome; Female; Humans; Imidazoles - administration & dosage; Imidazoles - adverse effects; Inhibidores MAPK; MAP Kinase Kinase Kinases - antagonists & inhibitors; MAPK inhibitors; Melanoma; Melanoma - drug therapy; Melanoma - secondary; Neoplasm Proteins - antagonists & inhibitors; Oximes - administration & dosage; Oximes - adverse effects; Panuveitis; Panuveitis - chemically induced; Panuveitis - drug therapy; Panuveítis; Piperidines - administration & dosage; Piperidines - adverse effects; Proto-Oncogene Proteins B-raf - antagonists & inhibitors; Pyridones - administration & dosage; Pyridones - adverse effects; Pyrimidinones - administration & dosage; Pyrimidinones - adverse effects; Retinal Detachment - chemically induced; Serous retinal detachment; Trametinib; Vemurafenib - administration & dosage
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2018.05.002

The case is presented of a 39-year-old woman with metastatic melanoma treated with dabrafenib and trametinib. She presented with a severe acute panuveitis with granulomatous anterior uveitis, vitritis, and multiple serous retinal detachments. Dabrafenib and trametinib were suspended, and treatment with a systemic and topical corticosteroid was started. A good response was obtained, with a recovery of visual acuity of 1.0 in both eyes within two weeks. Dabrafenib and trametinib can lead to severe uveitis. Treatment with corticosteroids and discontinuation of therapy with dabrafenib and trametinib led to an anatomical and functional improvement, and resolved the episode rapidly. Ophthalmologists must be aware of this toxicity, given the increasing use of those drugs. Presentamos el caso de una mujer de 39 años de edad con un melanoma metastásico en tratamiento con dabrafenib y trametinib, que desarrolló una panuveítis severa aguda con uveítis anterior granulomatosa, asociada a vitritis y múltiples desprendimientos serosos de retina. El tratamiento con dabrafenib y trametinib fue suspendido iniciándose corticoterapia tópica y sistémica, apreciándose una buena respuesta y recuperando una agudeza visual de 1,0 en ambos ojos en 2 semanas. El dabrafenib y el trametinib pueden producir una severa panuveítis. El tratamiento con corticoides y la suspensión de dabrafenib y trametinib consiguió controlar la uveítis, con recuperación de la agudeza visual, rápidamente. Los oftalmólogos debemos conocer este tipo de toxicidad debido al creciente uso de estos fármacos.