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Updated: Feb 26, 2026
Multifocal Electroretinograms
Published on: December 4, 2011
Clinical and Morphologic Characteristics of MEK Inhibitor-Associated Retinopathy: Differences from Central Serous
Jasmine H Francis1, Larissa A Habib2, David H Abramson1
1Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Weill-Cornell Medical Center, New York, New York.
Purpose:
To investigate the clinical and morphologic characteristics of serous retinal disturbances in patients taking mitogen-activated protein kinase kinase (MEK) inhibitors.
Participants:
A total of 313 fluid foci in 50 eyes of 25 patients receiving MEK inhibitors for treatment of their metastatic cancer, who had evidence of serous retinal detachments confirmed by optical coherence tomography (OCT).
Design:
Single-center, retrospective cohort study.
Methods:
Clinical examination 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 interobserver findings and compare choroidal thickness and visual acuity at each time point.
Main Outcome Measures:
Comparison of OCT characteristics of retinal abnormalities at baseline to fluid accumulation.
Results:
The majority of patients had fluid foci that were bilateral (92%) and multifocal (77%) and at least 1 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 4 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 2 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 interobserver 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.
Insights
Mitogen-activated protein kinase kinase (MEK) inhibitors can cause unique subretinal fluid disturbances in patients with cancer. These unique fluid foci did not lead to irreversible vision loss in this study.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Mitogen-activated protein kinase kinase (MEK) inhibitors are used to treat metastatic cancers.
- Serous retinal disturbances have been anecdotally reported in patients receiving MEK inhibitors.
- Understanding these ocular side effects is crucial for patient management.
Purpose of the Study:
- To characterize the clinical and morphologic features of serous retinal disturbances in patients treated with MEK inhibitors.
- To differentiate these findings from other retinal conditions like central serous chorioretinopathy.
Main Methods:
- Retrospective cohort study of 25 patients (50 eyes) with metastatic cancer treated with MEK inhibitors.
- Optical coherence tomography (OCT) and clinical examinations were used to evaluate subretinal fluid.
- Morphology, distribution, and location of fluid foci were analyzed, along with choroidal thickness and visual acuity.
Main Results:
- 313 subretinal fluid foci were identified, predominantly bilateral and multifocal, often involving the fovea.
- Four distinct morphologies of fluid foci were observed: dome, caterpillar, wavy, and splitting.
- No statistically significant difference in visual acuity or choroidal thickness was found between baseline, fluid accumulation, and resolution, indicating no irreversible vision loss.
Conclusions:
- Subretinal fluid associated with MEK inhibitors presents unique morphologic characteristics.
- These findings are distinguishable from central serous chorioretinopathy.
- MEK inhibitor treatment did not result in irreversible vision loss or serious ocular damage in this cohort.
