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首页> 外文期刊>Retinal cases & brief reports >BILATERAL VISUAL FIELD DEFECTS IN A PATIENT TREATED WITH THE MEK AND BRAF INHIBITORS TRAMETINIB AND DABRAFENIB FOR MELANOMA OF UNKNOWN ORIGIN
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BILATERAL VISUAL FIELD DEFECTS IN A PATIENT TREATED WITH THE MEK AND BRAF INHIBITORS TRAMETINIB AND DABRAFENIB FOR MELANOMA OF UNKNOWN ORIGIN

机译：用MEK和BRAF抑制剂治疗的患者的双侧视野缺陷Trametinib和DabrafeNib用于未知起源的黑色素瘤

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Introduction: Although the introduction of BRAF and MEK inhibitors has greatly enhanced treatment possibilities in advanced BRAFV600-mutated melanoma, class-related toxicities are rather frequent and often involve the eye. Ophthalmologic side effects most commonly include central/diffuse serous retinopathy and retinal vein occlusion. Affection of the optic nerve head however has not been described clinically. Case report: A 29-year-old man presented in our eye clinic with bilateral blurred vision. Seventeen days earlier, he had been started on trametinib and dabrafenib combination therapy for metastasized melanoma of unknown origin. Visual field testing revealed diffuse bilateral defects, which regressed spontaneously on pause of MEK and BRAF inhibitor treatment. Discussion: In addition to the widely known class-related retinal toxicity, MEK and BRAF inhibitor-associated adverse events may also involve the optic nerve head, causing visual field defects probably regressing spontaneously after discontinuation of targeted oncologic therapy. In such cases, repeat brain imaging and exclusion of melanoma-associated retinopathy is recommended. Reinitiation of treatment and subsequent dose escalation seem to be feasible, but should be monitored by an ophthalmologist.
机译：简介：虽然BRAF和MEK抑制剂的引入大大提高了治疗可能性，但在高级BRAFV600突变的黑色素瘤中，课堂相关毒性相当频繁，往往涉及眼睛。眼科副作用最常包括中央/弥漫性浆膜视网膜病变和视网膜静脉闭塞。然而，视神经头的影响尚未临床描述。案例报告：一名29岁的男子在我们的眼科诊所呈现，双边模糊的视野。早些时候十七天，他已经开始在Trametinib和Dabrafenib组合治疗中进行了未知起源的转移的黑色素瘤。视野测试显示弥漫性双侧缺陷，其自发地回归MEK和BRAF抑制剂治疗。讨论：除了众所周知的类相关视网膜毒性外，MEK和BRAF抑制剂相关的不良事件也可能涉及视神经头，在停止靶向肿瘤治疗后，导致视野缺陷可能会自发地回归。在这种情况下，建议重复脑成像和排除黑素瘤相关视网膜病变。治疗和随后的剂量升级似乎是可行的，但应由眼科医生监测。

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