Lorlatinib-Induced Blindness: A Rare Entity

Lorlatinib is a central nervous system-penetrant third-generation tyrosine kinase inhibitor approved for the first-line management of metastatic non-small cell lung cancer with anaplastic lymphoma kinase rearrangement,¹ which accounts for 3% to 5% of non-small cell lung cancer cases.² The most commonly reported side effects include hyperlipidemia, edema, peripheral neuropathy, and central nervous system effects.² Whereas ocular side effects such as photopsia, blurred vision, vitreous floaters, and diplopia have been documented with another anaplastic lymphoma kinase-tyrosine kinase inhibitor, crizotinib, there are few reports of such effects with lorlatinib.³ Herein, we present a case of bilateral optic neuropathy, initially misdiagnosed as optic nerve metastases and treated with palliative radiation therapy.