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55 year old Caucasian female with a history of bladder cancer was referred for retinal abnormalities. VA 20/25 and 20/30

DIAGNOSIS

Differential Diagnosis

• Central serous chorioretinopathy
• Medication toxicity

Definitive Diagnosis

• Fibroblast Growth Factor Receptor (FGFR) Inhibitor–Associated Retinopathy (aka FGFR inhibitor associated pseudocentral chorioretinopathy)

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Discussion:

Fibroblast Growth Factor Receptor Antagonists

• Epidemiology: Few studies on FGFR antagonist associated retinopathy. Francis et al. reported 20 of 146 patients who developed retinopathy as a consequence of FGFR antagonist medication in a case study published in October 2021 in JAMA Ophthalmology.
• Presentation: asymptomatic or mildly symptomatic subretinal fluid.
• Clinical Course: self-resolving without medication discontinuation (Francis et al.). However, only few studies have described the condition, and all were retrospective.
• Management: No RCTs to guide best therapeutic strategy but liaising with the oncologist is the best current option.
• Side Notes: The retinopathy seen with FGFR inhibitors is very similar to that shown with MEK and ERK inhibitors.
• Both have bilateral serous elevations that often surround the fovea.
• Fluid accumulates between the retinal pigment epithelium and the interdigitation zone on OCT.

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