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Cobimetinib/vemurafenib Acute corneal decompensation and acute corneal epithelial and stromal oedema: case report

A 38-year-old man developed acute corneal epithelial and stromal oedema and acute corneal decompensation during treatment with cobimetinib and vemurafenib for BRAF-mutated metastatic melanoma. The man with a diagnosis of BRAF-mutated metastatic melanoma was referred to a clinic. He had been receiving treatment with oral cobimetinib 60mg daily for 21 days/7 day off in combination with vemurafenib 960mg twice daily. At presentation, he had symptoms of photophobia in his right eye and blurred vision. His visual acuity was 3/10 and 9/10 in his right and left eyes, respectively. His intraocular pressure was 17mm Hg in the left eye and 14mm Hg in the right eye. A slit-lamp examination revealed epithelial microcystic oedema and bilateral central corneal stromal opacity. Involvement was more severe in the right eye. No cells/ flare was observed in the anterior chamber. His fundoscopic examination was normal. He received topical preservative‑free lubricant drops for symptomatic relief. His symptoms and slit-lamp findings were largely resolved 14 days after the first visit. His visual acuity was 10/10 bilaterally. This acute corneal decompensation case was due to endothelium pump failure. The corneal oedema resolved despite continuation of the drug therapy. Asfuroglu M, et al. A novel side effect of mitogen-activated protein kinase inhibitor cobimetinib: Acute corneal decompensation. Indian Journal of Ophthalmology 67: 803504088 2073-2075, No. 12, Dec 2019. Available from: URL: http://doi.org/10.4103/ijo.IJO_2025_18

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Reactions 3 Oct 2020 No. 1824