Bilateral multifocal central serous retinopathy due to management of metastatic melanoma with BRAf MEK inhibitors: Case report

Abstract

Central serous retinopathy (CSR) is a lesser-established ocular toxicity associated with BRAF/MEK inhibitors, a targeted treatment used in BRAF-mutated melanoma. This case study outlines a patient with metastatic cutaneous melanoma, who developed bilateral multifocal CSR secondary to dabrafenib and trametinib, two commonly used BRAF/MEK inhibitors. This report aims to improve the understanding of CSR as an adverse effect of BRAF/MEK inhibitors, including the potential for sight threatening ocular toxicity. It also aims to emphasise the importance of multi-specialty management to manage such toxicity while upholding delivery of cancer treatment in the best interests of the patient. In this case, the BRAF/MEK inhibitors were re-commenced at half dose and the CSR did not further progress, demonstrating an alternative option to halting treatment or switching to second-line therapy. Ultimately, a risk versus benefit approach is required, with decision making involving the multi-disciplinary team centred around an informed patient.

Keywords

• Central serous retinopathy
• BRAF/MEK inhibitors
• Dabrafenib
• Trametinib
• Case report