Coutu A, Farguette F, Jeannin G, Chiambaretta F
Service d'ophtalmologie, CHU Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Service d'ophtalmologie, CHU Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
J Fr Ophtalmol. 2016 Jan;39(1):55-63. doi: 10.1016/j.jfo.2015.05.009. Epub 2015 Dec 30.
New targeted treatments are being used for patients affected by certain types of cancers with specific gene dysregulation. These new treatments transform the prognosis for the patients but the exact way in which they work is often incompletely known. This can prove to be problematic with regard to potential side effects. Ophthalmologic side effects are particularly difficult to detect in animal models. MEK inhibitors are among these new targeted treatments for which the indications are broad. One of the reported side effects of MEK inhibitors is the appearance of atypical multifocal serous chorioretinopathies which, when present, occur rapidly after starting the treatment and disappear soon after stopping it. We report two documented cases of serous chorioretinopathies secondary to the use of selumetinib, an MEK inhibitor. Both patients were followed for several months after initiating the treatment, using angiography, OCT, and filtered photographs. Only a very few cases have been reported, and the detailed description of two clear-cut cases and their management, as well as a review of the current literature, seems a good way to approach the management of this complication.
新的靶向治疗方法正在用于患有特定基因失调的某些类型癌症的患者。这些新疗法改变了患者的预后,但它们的确切作用方式往往并不完全清楚。这在潜在副作用方面可能会带来问题。眼科副作用在动物模型中特别难以检测。MEK抑制剂是这些适应症广泛的新靶向治疗方法之一。MEK抑制剂报告的副作用之一是非典型多灶性浆液性脉络膜视网膜病变的出现,这种病变一旦出现,在开始治疗后迅速发生,并在停药后很快消失。我们报告了两例使用MEK抑制剂司美替尼继发浆液性脉络膜视网膜病变的记录病例。两名患者在开始治疗后均接受了数月的随访,使用了血管造影、光学相干断层扫描(OCT)和滤过照片。仅有极少数病例被报道,对两例明确病例及其处理的详细描述,以及对当前文献的综述,似乎是处理这种并发症的一个好方法。