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维莫非尼诱导葡萄膜炎患者玻璃体内注射甲氨蝶呤的疗效观察。

INTRAVITREAL METHOTREXATE IN VEMURAFENIB-INDUCED UVEITIS.

机构信息

Department of Ophthalmology, Erasme Hospital, Brussels, Belgium.

Head of the Oncology Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; and.

出版信息

Retin Cases Brief Rep. 2024 Jul 1;18(4):455-458. doi: 10.1097/ICB.0000000000001419.

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.

摘要

目的

BRAF 抑制剂维莫非尼改变了晚期黑色素瘤患者的预后,但同时也引发了人们对其潜在不良反应的关注。本文报告了一例维莫非尼诱导的葡萄膜炎,其表现和治疗极具特点。

方法

病例报告、诊断和治疗挑战。

结果

葡萄膜炎是维莫非尼的已知副作用。其通常为双侧、中度,可通过局部皮质类固醇治疗控制,且无需停止癌症治疗。本文报告了一位患者在接受维莫非尼治疗后出现单侧、重度葡萄膜炎,由于常规皮质类固醇治疗禁忌,经玻璃体内注射甲氨蝶呤后完全缓解。

结论

葡萄膜炎是维莫非尼的一种严重眼部不良反应,但其危险因素和机制尚不清楚。由于 BRAF 抑制剂现在已常规使用,因此临床医生必须了解这种可能威胁视力的副作用。对于严重的靶向药物诱导的葡萄膜炎,玻璃体内注射甲氨蝶呤可能是一种有效的治疗选择。

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