ABSTRACT
PURPOSE: To describe a case of ocular inflammation associated with dabrafenib and trametinib chemotherapy for cutaneous melanoma by using a multimodal image approach. MATERIALS AND METHODS: We report on a 51-year-old woman with Vogt-Koyanagi-Harada-like syndrome, which occurred while she was undergoing treatment with dabrafenib and trametinib for cutaneous melanoma. The patient complained of sudden, bilateral vision loss of 2 days' duration. Anatomical and functional improvement was observed after administration of systemic steroids and cessation of chemotherapy. Later on, 6 weeks after restarting dabrafenib, she had an episode of granulomatous anterior uveitis, which was successfully managed with topical mydriatics and steroids. Strict follow-up with multimodal imaging was performed until recovery. CONCLUSIONS: This report emphasizes the importance of strict ophthalmological follow-up with multimodal imaging in patients receiving dabrafenib and trametinib, and the need for a multidisciplinary approach in the management of ocular inflammation during chemotherapy.
Subject(s)
Iridocyclitis , Melanoma , Skin Neoplasms , Uveitis , Uveomeningoencephalitic Syndrome , Female , Humans , Middle Aged , Melanoma/diagnosis , Melanoma/drug therapy , Melanoma/complications , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Skin Neoplasms/complications , Uveomeningoencephalitic Syndrome/chemically induced , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/drug therapy , Uveitis/complications , Iridocyclitis/complications , Inflammation/complications , Multimodal Imaging , Melanoma, Cutaneous MalignantABSTRACT
PURPOSE: To evaluate the role of multimodal imaging in the diagnosis and monitoring of patients with osteogenesis imperfecta complicated with choroidal neovascularization. CASE REPORT: A 28-year-old man, diagnosed with osteogenesis imperfecta, was referred 2 months after the appearance of central scotoma and metamorphopsia in the right eye. The patient underwent a complete ophthalmological evaluation including visual acuity examination as well as ophthalmoscopy, spectral-domain optical coherence tomography, optical coherence tomography angiography, fundus autofluorescence imaging, fluorescein angiography and microperimetry. Complete examination revealed macular lacquer crack with subretinal haemorrhage. A further investigation with spectral-domain optical coherence tomography and fluorescein angiography revealed the presence of choroidal neovascularization without clear activity associated to the lacquer crack. After a 1-month follow-up, both visual acuity and retinal sensitivity improved spontaneously. CONCLUSION: Collagen deficiency of osteogenesis imperfecta leads to fragility of the Bruch's membrane; tension forces probably act at this level determining ruptures with bleeding and choroidal neovascularization formation. Multimodal imaging and functional evaluation are needed to assess retinal alterations in patients with osteogenesis imperfecta, whereas treatment of choroidal neovascularization should be reserved only for active lesion to prevent evolution and visual acuity decrement.
