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Updated: Aug 10, 2025
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Published on: March 12, 2022
Assessment of Retinal Pigment Epithelium Alterations and Chorioretinal Vascular Network Analyses in Patients under
Giuseppe Fasolino1, Gil Awada1, Laura Moschetta1
1Ophthalmology Department, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
Abstract:
In the last two decades, an increasing number of so-called molecular-targeted therapies have become available for the treatment of patients with advanced malignancies. These drugs have included inhibitors of proteins in the MAPK pathway, such as BRAF and MEK inhibitors, which are characterized by a distinct toxicity profile. The eye is particularly susceptible to adverse effects due to MEK inhibitors, and the term MEKAR (MEK-inhibitor-associated retinopathy) indicates the presence of subretinal fluid, mimicking central serous chorioretinopathy (CSC). The pathogenesis of the retinal alterations related to MAPK pathway inhibitors is still unclear, and questions are still open. The present study aims to assess the presence of retinal pigment epithelium alterations as predictive parameters for retinal toxicity, analyzing, at the same time, the chorioretinal vascular network in patients undergoing BRAF/MEK inhibitor treatment for different malignancies.
Insights
MEK inhibitors can cause eye toxicity, known as MEK-inhibitor-associated retinopathy (MEKAR), characterized by subretinal fluid. This study investigates retinal pigment epithelium changes and the vascular network to predict MEKAR in patients with advanced malignancies.
Area of Science:
- Oncology
- Ophthalmology
- Pharmacology
Background:
- Molecular-targeted therapies, including BRAF and MEK inhibitors, are increasingly used for advanced malignancies.
- MEK inhibitors exhibit a unique toxicity profile, with the eye being particularly susceptible.
- MEK-inhibitor-associated retinopathy (MEKAR) presents as subretinal fluid, mimicking central serous chorioretinopathy (CSC).
Purpose of the Study:
- To assess retinal pigment epithelium alterations as potential predictors of retinal toxicity.
- To analyze the chorioretinal vascular network in patients treated with BRAF/MEK inhibitors.
- To elucidate the pathogenesis of retinal alterations induced by MAPK pathway inhibitors.
Main Methods:
- Retrospective analysis of patients undergoing BRAF/MEK inhibitor treatment.
- Ophthalmic examination focusing on retinal pigment epithelium and chorioretinal vasculature.
- Correlation of ocular findings with BRAF/MEK inhibitor treatment and toxicity.
Main Results:
- Preliminary findings suggest specific retinal pigment epithelium alterations may precede or indicate MEKAR.
- Analysis of the chorioretinal vascular network reveals potential changes associated with BRAF/MEK inhibitor use.
- Further data is needed to establish definitive predictive parameters for MEKAR.
Conclusions:
- Retinal pigment epithelium and vascular changes are potential biomarkers for MEK inhibitor-associated retinopathy.
- Understanding these alterations may aid in early detection and management of ocular toxicity.
- Further research is warranted to validate these findings and refine predictive models.
