Schoenberger Scott D, Kim Stephen J
Department of Ophthalmology, Vanderbilt Eye Institute, 2311 Pierce Avenue, Nashville, TN 37232, USA.
Case Rep Ophthalmol Med. 2013;2013:673796. doi: 10.1155/2013/673796. Epub 2013 Mar 11.
Newer chemotherapeutic agents target extracellular signaling, including the mitogen-activated protein kinase kinase (MEK) pathway. We present a case of a 54-year-old female who developed bilateral multifocal central serous-like chorioretinopathy shortly after starting MEK inhibition for metastatic cutaneous melanoma. There was a complete resolution of findings after drug stoppage. After resuming a lower dose of the MEK inhibitor, the findings recurred again but resolved after drug stoppage. Other etiologies were unlikely given the clinical course. The presumed mechanism involves toxicity to the retinal pigment epithelium, with breakdown of the blood-retinal barrier. Recognition of this side effect is important with this new class of chemotherapy.
新型化疗药物作用于细胞外信号传导，包括丝裂原活化蛋白激酶激酶（MEK）通路。我们报告一例54岁女性病例，该患者在开始使用MEK抑制剂治疗转移性皮肤黑色素瘤后不久，出现双侧多灶性中心性浆液性脉络膜视网膜病变样病变。停药后病变完全消退。重新使用较低剂量的MEK抑制剂后，病变再次出现，但停药后又消退。鉴于临床病程，其他病因可能性不大。推测其机制涉及对视网膜色素上皮的毒性作用，导致血视网膜屏障破坏。认识到这类新型化疗药物的这一侧效应很重要。
