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Adeel Khan, Christopher Garrett, Bernard F. Godley, Ghassan Ghorayeb, Bita Esmaeli, Dan S. Gombos, Jade Schiffman, Stella K. Kim; Central Serous Retinopathy in Cancer Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):934.
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To describe central serous retinopathy (CSR) in cancer patients from a tertiary cancer center.
IRB-approved retrospective review was conducted for patients diagnosed with CSR from MD Anderson Cancer Center from January 2000- July 2011. Chart review included patients’ demographics, cancer and its treatment history, ocular presentation, and follow-ups. Literature review was performed for current data on CSR in cancer patients.
18 cases were identified with mean follow up of 7.2 months (range 1-18 months) for 13 patients (5 were lost to followup after CSR).The patients’ demographics included age range of 20 to 76 with median age of 42.3 years. 67% of patients were male and 33% female. Cancer diagnoses included leukemia(8), lymphoma (2) and 8 solid organ cancers (gastrointestinal(1), breast(1), testicular(1), lung(1), brain(1), melanoma (1), renal cell (1), tonsillar cancer(1)). 50% of patients were in remission from their cancer and 50% were in active treatment. 67% of patients were on systemic steroid, 11% patients were on clinical trial on MEK (mitogen activated protein kinase) inhibitor, and 33% patients developed CSR without any obvious precipitating medication. One patient had whole brain radiation including the posterior orbit, without any other evidence of radiation retinal toxicities. Initial vision ranged from 20/20 to counting fingers. Diagnoses were made with funduscopic evaluation, fluorescein angiography, and when available, optical coherence tomography (OCT). Of the 13 patients with available followup, 69% (9/13) patients had resolution of CSR by mean followup of 7.6 weeks (range 3-19). Of those with complete resolution, 4/9 patients were observed without treatment, 3/9 patients required discontinuation of systemic steroids, 2/9 patients required discontinuation of MEK inhibitors. CSR recurred in 1 patient when MEK inhibitor was restarted at a lower dose but resolved completely when it was discontinued for the second time. Among the 4 patients who did not improve during their followup with MDACC, 3 were treated at an outside facility and 1 died within 1 month. Overall, 44.4% (8/18) patients died with the mean survival of 4.7 months from the diagnosis of CSR (range 0.4-11). There is paucity of data regarding CSR in cancer patients in the literature.
CSR in cancer patients are described. This study marks first in the literature to describe CSR in the cancer population. Systemic steroid appears to play a role in CSR in majority of the cancer patients who develop CSR. Unlike systemic steroid, which is a known risk factor of CSR, MEK inhibitor appears to play a role in the development of CSR, which is also a new finding within the literature. Further studies are warranted.
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