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Case Reports
. 2022 Jun 3;6(4):332-336.
doi: 10.1177/24741264221092908. eCollection 2022 Jul-Aug.

Erdafitinib-Induced Secondary Maculopathy

Brian Becker  1 , Sophia El Hamichi  1 , Aaron S Gold  1 , Timothy G Murray  1
Affiliations
Case Reports

Erdafitinib-Induced Secondary Maculopathy

Brian Becker et al. J Vitreoretin Dis. .

Abstract

Purpose: This work presents a case of secondary maculopathy associated with the use of erdafitinib (Balversa) for the management of bladder urothelial carcinoma with bony metastasis.

Methods: A case report is presented.

Results: A 58-year-old Hispanic man presented with blurry vision 3 weeks after starting erdafitinib for the management of bony metastases associated with urothelial carcinoma. A comprehensive evaluation identified multiple areas of subretinal fluid induced by erdafitinib. Throughout treatment, the ocular condition progressed, causing worsening of vision; this led to discontinuation of the drug. Discontinuation was associated with visual and anatomic function improvement.

Conclusions: Fibroblast growth factor receptor (FGFR) plays a major role in maintaining mature and premature retinal pigment epithelium cells. Drugs that inhibit the FGFR pathway block the activation of the mitogen-activated protein kinase pathway, leading to synthesis of antiapoptotic proteins. Erdafitinib is associated with ocular toxicity and leads to multifocal pigment epithelial detachments associated with secondary subretinal fluid.

Keywords: FGFR; MAPK; RPE detachment; central serous chorioretinopathy; erdafitinib; mitogen-activated protein kinase retinopathy; targeted therapy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Ultra-widefield fundus photography of (A) the right eye and (B) the left eye shows macular oval serous detachment and scattered areas of retinal pigment epithelium mottling in the midperiphery. Optical coherence tomography of (C) the right eye and (D) the left eye shows macular subretinal fluid in both eyes and pigment epithelium detachment in the right eye.
Figure 2.
Figure 2.
The patient’s fingernails thickened and grew outward because of erdafitinib-induced onychauxis.
Figure 3.
Figure 3.
(A and B) Ultra-widefield fundus photography and (C and D) optical coherence tomography show improvement in both eyes after erdafitinib was withheld for 3 weeks.
Figure 4.
Figure 4.
Characteristics of mitogen-activated protein kinase inhibitor–associated retinopathy and central serous retinopathy (data adapted from Francis et al).
See this image and copyright information in PMC

References

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