Have a personal or library account? Click to login
Ocular changes in metastatic melanoma patients treated with MEK inhibitor cobimetinib and BRAF inhibitor vemurafenib Cover

Ocular changes in metastatic melanoma patients treated with MEK inhibitor cobimetinib and BRAF inhibitor vemurafenib

Open Access
|Jan 2018

Figures & Tables

Figure 1

(A) Discrete bilateral lesions in the fovea seen on fundus photography(blue arrows); (B) Infrared reflectance imaging showing lesions with a hyperreflective center, surrounded by a hyporeflective zone scattered throughout the posterior pole (some are marked with red arrows); (C) Some lesions showed increased signal in autofluorescence imaging (some are marked with yellow arrows).
(A) Discrete bilateral lesions in the fovea seen on fundus photography(blue arrows); (B) Infrared reflectance imaging showing lesions with a hyperreflective center, surrounded by a hyporeflective zone scattered throughout the posterior pole (some are marked with red arrows); (C) Some lesions showed increased signal in autofluorescence imaging (some are marked with yellow arrows).

Figure 2

(A-C) IR imaging of foveal lesion during cycles; (D-F) OCT showed fluctuations of dome-shaped accumulation of subretinal fluid with elongation of interdigitation zone (green arrows) in the foveal region; A+D = imaging during 3rd cycle; B+E = imaging during 6th cycle; C+F = imaging during 8th cycle.
(A-C) IR imaging of foveal lesion during cycles; (D-F) OCT showed fluctuations of dome-shaped accumulation of subretinal fluid with elongation of interdigitation zone (green arrows) in the foveal region; A+D = imaging during 3rd cycle; B+E = imaging during 6th cycle; C+F = imaging during 8th cycle.

Figure 3

Fluorescein (A, B) and indocyanine green (C, D) angiography showed only mild masking effect of subretinal fluid on the location of lesions (red arrows).
Fluorescein (A, B) and indocyanine green (C, D) angiography showed only mild masking effect of subretinal fluid on the location of lesions (red arrows).

Figure 4

Discrete morphological changes with focal elongations of interdgitation zone in the fovea (red arrows) and near the vascular arcades (green arrows) seen on OCT.
Discrete morphological changes with focal elongations of interdgitation zone in the fovea (red arrows) and near the vascular arcades (green arrows) seen on OCT.

Patient characteristics

Patient N°1234567
SexMMFMMMM
Age (years)41586474714555
No of cycles at first eye exam211153336
No of cycles at last eye exam313248547
Change in dosageyes

adjusted dose = lower dose due to the cutaneous side effects

nononononono
BCVA RE1.01.01.00.7 – 0.90.81.01.0
BCVA LE1.01.01.00.7 – 0.90.71.01.0
Symptomscircle centrallyblurred visionnoblurred visionfloaters in LE, blurred visioncircle centrallyno
Occurrence of symptoms after starting the therapy1 week1 week-1 week1 month1 week-
Fluctuations of symptomsspontan. resolutionno-different spectacles neededbetter after topical therapyspontan. resolutionneeds spectacles
OCT changes in the foveaelongatio of IZSRFSRFSRFelongation of IZ in RE, SRF in LESRFSRF
Extrafoveal SRFmultiple bilateralmultiple bilateralmultiple bilateralmultiple bilateralnonomultiple bilateral
Other ocular findings---incipient senile cataract ouuveitis in LE; incipient cataract ou-dilatated conjuctival vessels in the RE
DOI: https://doi.org/10.2478/raon-2018-0002 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 213 - 219
Submitted on: Oct 4, 2017
Accepted on: Nov 20, 2017
Published on: Jan 24, 2018
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2018 Ana Ursula Gavric, Janja Ocvirk, Polona Jaki Mekjavic, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.