A Case Report and Literature Review of Vogt-Koyanagi-Harada-Like Uveitis Secondary to Dabrafenib and Trametinib: 4-Year Follow-Up Using Retinal Multimodal Imaging


UÇAN GÜNDÜZ G., Gullulu Z. Z., NİZAM TEKCAN S., YALÇINBAYIR Ö., ÇUBUKÇU E.

Ocular Immunology and Inflammation, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1080/09273948.2024.2401626
  • Dergi Adı: Ocular Immunology and Inflammation
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: Dabrafenib, multimodal imaging, survival, Trametinib, VKH-like uveitis
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Purpose: To report a case of Vogt-Koyanagi-Harada (VKH)-like uveitis under treatment with Dabrafenib and Trametinib for metastatic malignant melanoma, representing the longest follow-up (49 months) with retinal multimodal imaging. Methods: Retrospective case report. Results: A 49-year-old female with metastatic relapsing cutaneous malignant melanoma presented with blurry vision in both eyes for 1 week. She had been treated with Dabrafenib and Trametinib for 2 months. Fundus examination detected serous retinal detachments (SRDs) and hyperemic optic disks. Spectral-domain optical coherence tomography (SD-OCT) revealed SRDs, retinal pigment epithelium undulations, choroidal thickening, and loss of normal choroidal vascular architecture. The patient was diagnosed with VKH-like uveitis secondary to targeted agents since systemic investigations were unremarkable. Dabrafenib and Trametinib were discontinued, and pulse steroid treatment was started. Following the improvement of retinal and choroidal signs, the same targeted agents were restarted 6 weeks later. No recurrence of uveitis occurred during 49 months of follow-up; however, the convalescent phase findings of VKH were observed in the fundus examination. The systemic status of the patient, who is still using Dabrafenib and Trametinib, is stable. Conclusion: Although the mechanism is still unknown, the development of VKH-like uveitis secondary to targeted therapy may indicate successful tumor control in patients with metastatic melanoma. Providing effective immunosuppression with corticosteroids and making necessary dose modifications with a multidisciplinary approach may extend the survival of patients.