A Rare Cause of Uveitis: Vemurafenib

Abstract

A 25-year-old female presented with a decrease of vision and redness in both eyes. She had a history of nodular melanoma in her right shoulder, which was excised surgically and she was under oral vemurafenib treatment. She was diagnosed with moderately severe bilateral panuveitis and hospitalized for systemic investigation and workup. The laboratory test results were unremarkable and systemic workup failed to reveal an etiology. The condition was considered vemurafenib-induced uveitis, as the drug is known to be associated with uveitis. After reevaluation with the oncology department, vemurafenib was stopped and topical and systemic corticosteroid therapy was started. The uveitis resolved and her vision returned to normal. No sign of recurrence was detected at 8-month follow-up.

The Impact of Systemic Medications on Retinal Function

“…Anterior uveitis is the most common side-effect, but Vogt-Koyanagi-Harada-like uveitis and panuveitis are less commonly reported. [473][474][475][476][477][478] Acute exudative paraneoplastic polymorphous vitelliform maculopathy after starting vemurafenib in a patient already on pembrolizumab was reported in a single case report. 479…”

Cancer Immunotherapy and Uveitis: Balancing Anti-Tumor Immunity and Ocular Autoimmunity

“…Out of those patients with anterior uveitis, 2 were continued on vemurafenib while 2 discontinued the medication; all were treated with topical corticosteroid therapy with resolution of signs and symptoms, regardless of vemurafenib status. Sizmaz et al 75 report a case of bilateral panuveitis that resolved with cessation of vemurafenib, oral, and topical steroids. Wolf et al 76 report a similar case of a patient who developed severe bilateral panuveitis with improvement in symptoms after vemurafenib cessation, oral and topical steroids.…”

Sarcoid-like Granulomatous Intraocular Inflammation Caused by Vemurafenib Treatment for Metastatic Melanoma

“…1,2 Vemurafenib-related uveitis has been reported in phase I, II, and III clinical trials, case reports, and case series in the literature. [3][4][5][6][7] In addition to this, there is an article in the literature that reported 5 patients with sarcoidosis related to vemurafenib therapy for metastatic melanoma. 8 Sarcoidosis is a multisystem granulomatous disease of unknown etiology.…”