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Cabozantinib-Associated Exudative Retinal Detachment and Choroiditis: A Case Report
Kirk A J Stephenson1, Bryon R McKay1, Katherine E Paton1
1Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada.
Purpose:
To describe the first reported instance of an acute chorioretinal inflammatory response to cabozantinib.
Methods:
Case report.
Results:
A 54-year-old Asian male presented with blurred vision 2 weeks following the commencement of cabozantinib for metastatic renal cell carcinoma. Ophthalmic examination revealed bilateral exudative retinal detachments and choroiditis in a pattern similar to Vogt-Koyanagi-Harada disease. Further investigations revealed latent tuberculosis (TB), and management of this ocular adverse event was with cabozantinib cessation, high-dose oral prednisone, single-agent anti-TB therapy, and methotrexate. Return of visual function and ocular anatomy occurred within 1 month.
Conclusions:
Modern pharmacotherapy for metastatic cancer may increase survival, but a range of ocular and systemic adverse events are frequently seen. Screening and early intervention can mitigate adverse events and treatment burden, while maximizing benefits for this disadvantaged patient group.
