Clinical and morphologic characteristics of MEK inhibitor - Associated retinopathy: Differences from central serous chorioretinopathy Journal Article


Authors: Francis, J. H.; Habib, L. A.; Abramson, D. H.; Yannuzzi, L. A.; Heinemann, M.; Gounder, M. M.; Grisham, R. N.; Postow, M. A.; Shoushtari, A. N.; Chi, P.; Segal, N. H.; Yaeger, R.; Ho, A. L.; Chapman, P. B.; Catalanotti, F.
Article Title: Clinical and morphologic characteristics of MEK inhibitor - Associated retinopathy: Differences from central serous chorioretinopathy
Abstract: Purpose To investigate the clinical and morphologic characteristics of serous retinal disturbances in patients taking mitogen-activated protein kinase kinase (MEK) inhibitors. Participants A total of 313 fluid foci in 50 eyes of 25 patients receiving MEK inhibitors for treatment of their metastatic cancer, who had evidence of serous retinal detachments confirmed by optical coherence tomography (OCT). Design Single-center, retrospective cohort study. Methods Clinical examination and OCT were used to evaluate MEK inhibitor–associated subretinal fluid. The morphology, distribution, and location of fluid foci were serially evaluated for each eye. Choroidal thickness was measured at each time point (baseline, fluid accumulation, and fluid resolution). Two independent observers performed all measurements. Statistical analysis was used to correlate interobserver findings and compare choroidal thickness and visual acuity at each time point. Main Outcome Measures Comparison of OCT characteristics of retinal abnormalities at baseline to fluid accumulation. Results The majority of patients had fluid foci that were bilateral (92%) and multifocal (77%) and at least 1 focus involving the fovea (83.3%). All fluid foci occurred between the interdigitation zone and an intact retinal pigment epithelium. The 313 fluid foci were classified into 4 morphologies, as follows: 231 (73.8%) dome, 36 (11.5%) caterpillar, 31 (9.9%) wavy, and 15 (4.8%) splitting. Best-corrected visual acuity at fluid resolution was not statistically different from baseline; and no eye lost more than 2 Snellen lines from baseline at the time of fluid accumulation. There was no statistical difference in the choroidal thickness between the different time points (baseline, fluid accumulation, and fluid resolution). A strong positive interobserver correlation was obtained for choroidal thickness measurements (r = 0.97, P < 0.0001) and grading of foci morphology (r = 0.97, P < 0.0001). Conclusion The subretinal fluid foci associated with MEK inhibitors have unique clinical and morphologic characteristics, which can be distinguished from the findings of central serous chorioretinopathy. In this series, MEK inhibitors did not cause irreversible loss of vision or serious eye damage. © 2017 American Academy of Ophthalmology
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; major clinical study; antineoplastic agents; comparative study; antineoplastic agent; neoplasm; neoplasms; metastasis; protein kinase inhibitor; cohort analysis; pyrimidinone derivative; pyridones; pyrimidinones; retrospective study; physiology; protein kinase inhibitors; retina detachment; retinal detachment; piperidines; mitogen activated protein kinase kinase; mitogen-activated protein kinase kinases; benzimidazole derivative; benzimidazoles; clinical examination; optical coherence tomography; fluorescein angiography; visual acuity; piperidine derivative; subretinal fluid; mitogen activated protein kinase kinase inhibitor; trametinib; pyridone derivative; tomography, optical coherence; very elderly; humans; human; male; female; priority journal; article; binimetinib; fluorescence angiography; retinal pigment epithelium; antagonists and inhibitors; chemically induced; azetidine derivative; gdc-0973; best corrected visual acuity; central serous retinopathy; choroidal thickness; azetidines; central serous chorioretinopathy
Journal Title: Ophthalmology
Volume: 124
Issue: 12
ISSN: 0161-6420
Publisher: Elsevier Science, Inc.  
Date Published: 2017-12-01
Start Page: 1788
End Page: 1798
Language: English
DOI: 10.1016/j.ophtha.2017.05.038
PUBMED: 28709702
PROVIDER: scopus
PMCID: PMC5698142
DOI/URL:
Notes: Article -- Export Date: 2 January 2018 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Neil Howard Segal
    98 Segal
  2. Jasmine Helen Francis
    97 Francis
  3. Michael Andrew Postow
    180 Postow
  4. David H Abramson
    249 Abramson
  5. Ping Chi
    44 Chi
  6. Rachel Nicole Grisham
    35 Grisham
  7. Paul Chapman
    246 Chapman
  8. Mrinal M Gounder
    68 Gounder
  9. Rona Denit Yaeger
    64 Yaeger
  10. Alan Loh Ho
    79 Ho
  11. Larissa Ann Habib
    8 Habib