MEK retinopathy: a case report

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The problem of adverse side effects affecting various organs and systems in patients receiving molecular targeted therapy for oncological diseases remains relevant. One group of such drugs are inhibitors of the MEK signaling pathway. These antineoplastic agents inhibit the mitogen-activated protein kinases MEK1 and/or MEK2 and are used, among other indications, in the treatment of cutaneous melanoma. In ophthalmology, ocular toxicity associated with MEK inhibitors has been defined as MEK retinopathy—a characteristic binocular toxic retinal lesion with multifocal foci of neuroepithelial retinal detachment resembling mercury droplets, which reduces visual acuity and often resolves spontaneously or upon discontinuation of targeted therapy. This article presents a clinical case of toxic retinopathy in a female patient receiving targeted therapy with trametinib and dabrafenib for the treatment of cutaneous melanoma. The clinical manifestations and diagnostic criteria of MEK retinopathy are described, differential diagnosis with central serous chorioretinopathy is provided, and the results of empirical therapy for this condition are presented, along with insights into its course and response to different treatment methods.

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作者简介

Alina Kalyuzhnaya

Diagnostic center No. 7 (ophthalmological) for adults and children, Saint Petersburg

编辑信件的主要联系方式.
Email: apkalyu@mail.ru
ORCID iD: 0009-0006-9969-7216

MD

俄罗斯联邦, Saint Petersburg

Aida Shakhnazarova

Diagnostic center No. 7 (ophthalmological) for adults and children, Saint Petersburg

Email: aida66@bk.ru
ORCID iD: 0000-0002-3053-5538

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Andrei Pokrovskii

Diagnostic center No. 7 (ophthalmological) for adults and children, Saint Petersburg

Email: pokrovas@gmail.com
ORCID iD: 0009-0004-6916-270X

MD

俄罗斯联邦, Saint Petersburg

参考

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2. Fig. 1. Photograph of the fundus: a - right eye; b - left eye.

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3. Fig. 2. Optical coherence tomography of the macular region of the right eye.

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4. Fig. 3. Optical coherence tomography of the macular region of the left eye.

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5. Fig. 4. Optical coherence tomography of the retina of the paracentral region (near the vascular arcades) of the right eye.

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6. Fig. 5. Photograph of autofluorescence of the fundus: a - right eye; b - left eye.

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7. Fig. 6. Fluorescein angiography of the fundus: a - right eye; b - left eye.

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8. Fig. 7. Optical coherence tomography of the macular region of the right eye after the introduction of betamethasone No. 1 into the sub-Tenon space.

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9. Fig. 8. Optical coherence tomography of the macular region: a - right eye initially; b - right eye after the introduction of betamethasone No. 2 into the sub-Tenon space.

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10. Fig. 9. Optical coherence tomography of the macular region: a - left eye initially; b - left eye after the introduction of betamethasone No. 1 into the sub-Tenon space.

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11. Fig. 10. Optical coherence tomography of the macular region: a - right eye, after the introduction of betamethasone No. 2 into the sub-Tenon space, discontinuation of targeted therapy; b - left eye, after the introduction of betamethasone No. 1 into the sub-Tenon space, discontinuation of targeted therapy.

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12. Fig. 11. Infrared image of the fundus of the left eye.

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