Purpose To investigate the clinical and morphologic characteristics of serous retinal disturbances in patients taking Mitogen-activated protein kinase kinase (MEK)-inhibitors. Participants 313 fluid foci in 50 eyes of 25 patients receiving MEK-inhibitors for treatment of their metastatic cancer, whom had evidence of serous retinal detachments confirmed by optical coherence tomography(OCT). Design Single center, retrospective, cohort study Methods Clinical exam and OCT were used to evaluate MEK-inhibitor associated subretinal fluid. The morphology, distribution and location of fluid foci were serially evaluated for each eye. Choroidal thickness was measured at each time point (baseline, fluid accumulation and fluid resolution). Two independent observers performed all measurements. Statistical analysis was used to correlate inter-observer findings, compare choroidal thickness and visual acuity at each time point. Main Outcom1e Measures Comparison of OCT characteristcs of retinal abnormalities at baseline to fluid accumulation. Results The majority of patients had fluid foci that were bilateral (92%), multifocal (77%) and at least one focus involving the fovea (83.3%). All fluid foci occurred between the interdigitation zone and an intact retinal pigment epithelium. The 313 fluid foci were classified into four morphologies as follows: 231 (73.8%) dome, 36 (11.5%) caterpillar, 31 (9.9%) wavy and 15 (4.8%) splitting. Best-corrected visual acuity at fluid resolution was not statistically different from baseline; and no eye lost more than two Snellen lines from baseline at the time of fluid accumulation. There was no statistical difference in the choroidal thickness between the different time points (baseline, fluid accumulation and fluid resolution). A strong positive inter-observer correlation was obtained for choroidal thickness measurements (r=0.97, p<0.0001) and grading of foci morphology (r=0.97, p<0.0001). Conclusion The subretinal fluid foci associated with MEK-inhibitors have unique clinical and morphologic characteristics, which can be distinguished from the findings of central serous chorioretinopathy. In this series, MEK-inhibitors did not cause irreversible loss of vision or serious eye damage.

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Intravitreal chemotherapy is successful for the treatment of subretinal seeds and recurrent retinal tumours and could be considered as adjunctive therapy in globe-sparing treatment of retinoblastoma.

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