Huang Yu-Te, Lin Chun-Ju, Tsai Yi-Yu, Hsia Ning-Yi
Department of Ophthalmology, China Medical University Hospital, Taichung.
School of Medicine, College of Medicine, China Medical University, Taichung.
Eur J Ophthalmol. 2023 May;33(3):NP56-NP59. doi: 10.1177/11206721221078675. Epub 2022 Feb 7.
Cabozantinib, which was approved by the Food and Drug Administration (FDA) in 2012, is a tyrosine kinase inhibitor widely used in the treatment of metastatic renal cell carcinoma (RCC) and medullary thyroid carcinoma. To date, no ocular adverse events have been reported by the FDA or on the package label. Here, we described a patient with metastatic RCC who developed bilateral optic disc edema after a 4-month course of cabozantinib.
A 55-year-old ethnic Chinese male with RCC with multiple metastases presented to our department with progressive blurred vision in both eyes for 1 month. He started taking cabozantinib 60 mg once daily 5 months prior to this presentation. Poor visual acuity and bilateral disc edema were then noted. Cabozantinib was discontinued after that, and 3-day pulse steroid therapy with methylprednisolone 1 g/day was given. The optic disc edema subsided gradually with limited improvement in visual acuity.
Bilateral optic edema should be considered as a complication associated with cabozantinib. We propose discontinuation of the treatment in cases such as that, and pulse steroid therapy should be considered if there is no contraindication.
卡博替尼于2012年获美国食品药品监督管理局（FDA）批准，是一种酪氨酸激酶抑制剂，广泛用于治疗转移性肾细胞癌（RCC）和甲状腺髓样癌。迄今为止，FDA或药品包装标签上均未报告过眼部不良事件。在此，我们描述了一名转移性RCC患者，在接受4个月的卡博替尼治疗后出现双侧视盘水肿。
一名55岁的华裔男性，患有伴有多处转移的RCC，因双眼进行性视力模糊1个月前来我院就诊。此次就诊前5个月，他开始每天服用一次60毫克卡博替尼。随后发现视力差和双侧视盘水肿。此后停用卡博替尼，并给予甲泼尼龙1克/天、为期3天的脉冲式类固醇治疗。视盘水肿逐渐消退，但视力改善有限。
双侧视神经水肿应被视为与卡博替尼相关的一种并发症。我们建议在出现此类情况时停用该治疗方法，并且如果没有禁忌证，应考虑进行脉冲式类固醇治疗。
