Separation of outer retinal layers secondary to selumetinib.
New therapeutic agents targeting the mitogen-activated protein (MAP) kinase pathway, including MEK inhibitors, are currently being evaluated in phase 1 and 2 clinical trials for pediatric brain tumors. Ophthalmologic side effects from MEK inhibitors have previously only been reported in adults and included retinal vein occlusion, central retinal artery occlusion, and separation of the neurosensory retina. We report 2 patients with optic pathway gliomas who developed outer retinal layer separation visualized by optical coherence tomography while taking the MEK inhibitor selumetinib. After discontinuation of selumetinib, the outer retinal layer separation resolved without visual sequelae. One patient has been retreated with selumetinib and experienced recurrence of these findings.
The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC; Center for Neuroscience and Behavior, Children's National Health System, Washington, DC. Electronic address: averyr@email.chop.edu.
Robert A
RA
Avery
The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC.
Carmelina
C
Trimboli-Heidler
Division of Oncology, Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC; The Brain Tumor Institute, Children's National Health System, Washington, DC.
Lindsay B
LB
Kilburn
D000181:Acrylonitrile / Q000009:adverse effects / Q000031:analogs & derivatives*; D000293:Adolescent; D000814:Aniline Compounds / Q000009:adverse effects*; D001254:Astrocytoma / Q000188:drug therapy*; D001562:Benzimidazoles / Q000009:adverse effects*; D002648:Child; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D019574:Optic Nerve Neoplasms / Q000188:drug therapy*; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D041623:Tomography, Optical Coherence
C517975:AZD 6244; D000814:Aniline Compounds; D001562:Benzimidazoles; C000610759:MEK inhibitor I; D000181:Acrylonitrile