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Impaired Retinal Circulation during Axitinib Treatment for Metastatic Renal Cell Carcinoma
Masashi Kimura1, Sentaro Kusuhara1, Mizuki Tagami2
1Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Purpose:
Axitinib, an orally administered vascular endothelial growth factor receptors 1, 2, and 3 inhibitor, is widely used as the second-line treatment for metastatic renal cell carcinoma. We present a case of metastatic renal cell carcinoma who developed a novel ocular adverse event, impaired retinal circulation, during axitinib therapy.
Methods:
This is an observational case report.
Results:
A 57-year-old male who had been treated with axitinib for metastatic renal cell carcinoma for 2 years presented in August 2015. He complained of sudden-onset abnormal visual field in his right eye. His right eye exhibited multiple soft exudates on fundus photography and a significant fluorescein filling delay of the retinal vessels on fluorescein angiography. His best corrected visual acuity (BCVA) was 20/20 in the right eye, and a cecocentral scotoma was detected by Goldmann perimeter. As axitinib could have been responsible for impaired retinal circulation, axitinib was terminated and switched to temsirolimus. The soft exudates gradually subsided and the patients' symptoms got better, but his right BCVA dropped to 20/63 3 months after the end of axitinib treatment with worsening of his general condition.
Conclusion:
Clinicians should be aware of retinal circulatory disorder that can occur in patients under axitinib treatment.
Insights
A patient on axitinib for metastatic renal cell carcinoma experienced impaired retinal circulation. Discontinuation of axitinib led to symptom improvement but vision loss, highlighting a potential ocular side effect.
Area of Science:
- Ophthalmology
- Medical Oncology
Background:
- Axitinib is a vascular endothelial growth factor receptor inhibitor used for metastatic renal cell carcinoma.
- Ocular adverse events associated with axitinib are not well-documented.
Observation:
- A case report of a 57-year-old male treated with axitinib for metastatic renal cell carcinoma.
- The patient presented with sudden visual field abnormalities in the right eye.
Findings:
- Fundus photography revealed multiple soft exudates.
- Fluorescein angiography showed delayed retinal vessel filling.
- Despite axitinib discontinuation and switch to temsirolimus, best corrected visual acuity decreased from 20/20 to 20/63.
Implications:
- Clinicians should monitor for retinal circulatory disorders in patients receiving axitinib.
- Impaired retinal circulation is a potential, serious ocular adverse event of axitinib therapy.
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