INTRAVITREAL METHOTREXATE IN VEMURAFENIB-INDUCED UVEITIS.

Artémise Dugauquier, Ahmad Hussein Awada, Elie Motulsky, Nacima Kisma
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Abstract

Purpose: Vemurafenib, a BRAF inhibitor, has revolutionized the prognosis of late-stage melanoma patients, rising at the same time concerns about its potential adverse effects. Here is a case of vemurafenib-induced uveitis, peculiar in both its presentation and management.

Methods: Case report, diagnostic, and therapeutic challenge.

Results: Uveitis is a known side effect of vemurafenib. It is generally bilateral, moderate, manageable with topical steroids, and does not require cancer therapy cessation. We present a patient who suffered from a unilateral, severe uveitis after vemurafenib treatment that fully recovered thanks to intravitreal methotrexate injections because conventional corticosteroid therapy was contraindicated.

Conclusion: Uveitis can be a serious ocular adverse effect of vemurafenib, whereas its risk factors and mechanisms remain unknown. As BRAF inhibitors are now used on a regular basis, it is important for clinicians to be aware of this potentially sight-threatening side effect. Intravitreal methotrexate injections may be considered as an effective treatment choice in severe targeted agents-induced uveitis.

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玻璃体内甲氨蝶呤治疗 vemurafenib 引起的葡萄膜炎。
目的:BRAF抑制剂维莫非尼彻底改变了晚期黑色素瘤患者的预后,但同时也引发了对其潜在不良反应的担忧。以下是一例维莫非尼诱发的葡萄膜炎病例,其表现和处理方法都很特别:方法:病例报告、诊断和治疗挑战:葡萄膜炎是维莫非尼的一种已知副作用。结果:葡萄膜炎是一种已知的副作用,一般为双侧、中度,局部使用类固醇即可控制,无需停止癌症治疗。我们介绍了一位在接受维莫非尼治疗后出现单侧严重葡萄膜炎的患者,由于禁用传统的皮质类固醇疗法,该患者在玻璃体内注射了甲氨蝶呤后完全康复:葡萄膜炎可能是维莫非尼的一种严重眼部不良反应,但其风险因素和机制尚不清楚。由于 BRAF 抑制剂已被常规使用,临床医生必须意识到这种可能危及视力的副作用。对于严重的靶向药物诱发葡萄膜炎,可考虑将玻璃体内注射甲氨蝶呤作为一种有效的治疗选择。
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来源期刊
Retinal Cases and Brief Reports
Retinal Cases and Brief Reports Medicine-Ophthalmology
CiteScore
2.10
自引率
0.00%
发文量
342
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