Bilateral Panuveitis and Exudative Retinal Detachments Associated with Alpelisib
Chong, Yu Jeat Tallouzi, Mohammad Omar Spooner, David Masood, Imran Ghosh, Yajati Sreekantam, Sreekanth
Chong, Yu Jeat
Tallouzi, Mohammad Omar
Spooner, David
Masood, Imran
Ghosh, Yajati
Sreekantam, Sreekanth
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Birmingham and Midland Eye Centre; Queen Elizabeth Hospital Birmingham
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Publication date
2022-08-03
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Abstract
We report a case of alpelisib-induced uveitis. A 68-year-old female who had recently been given alpelisib for metastatic breast cancer presented with a 2-week history of bilateral worsening vision with a corresponding acute hypermetropic shift. Her unaided visual acuity was 6/60 in both eyes, with bilateral anterior uveitis, non-granulomatous keratic precipitates, posterior synechiae, and limited fundal view. There was also a mild iris bombe configuration, although the intraocular pressures were normal. Ocular ultrasound revealed bilateral uveal effusion, ciliary body congestion, dense vitreous cells, and exudative retinal detachments. These findings were also confirmed on multimodal imaging with widefield fundus photography (Optos) and optical coherence tomography. Based on the clinical features above, a diagnosis of alpelisib-induced panuveitis was diagnosed. She was then admitted and treated with a 3-day course of intravenous methylprednisolone and intensive topical steroids. Her clinical signs and symptoms started to improve, and she was discharged 4 days later. At 1 week of follow-up, her best-corrected visual acuity was 6/12 in both eyes, with broken posterior synechiae and resolution of exudative retinal detachments. This case highlights the importance of early ophthalmology involvement by the oncology team as oncology therapy can have potential unexpected ocular manifestations.
Citation
Chong YJ, Azzopardi M, Tallouzi MO, Spooner D, Masood I, Ghosh Y, Sreekantam S. Bilateral Panuveitis and Exudative Retinal Detachments Associated with Alpelisib. Case Rep Oncol. 2022 Aug 3;15(2):713-719. doi: 10.1159/000525772.
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