Multifocal serous retinopathy with pemigatinib therapy for metastatic colon adenocarcinoma.
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2021-04
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Abstract
Background
Pemigatinib is an inhibitor of the fibroblast growth factor receptor (FGFR), recently approved for the treatment of cholangiocarcinoma. FGFR retinopathy is a newly recognized entity, with only two other FGFR inhibitors reported to cause serous retinopathy. Herein, we describe the first published report of a multifocal serous retinopathy secondary to pemigatinib.Case presentation
A 67-year-old male with stage 4A metastatic colon adenocarcinoma undergoing systemic therapy with pemigatinib was found to have developed bilateral multifocal serous retinopathy. Fundus autofluorescence showed corresponding multifocal hypoautofluorescent foci, whereas fluorescein angiography and indocyanine green angiography were unremarkable. Subretinal fluid resolved rapidly after discontinuation of pemigatinib.Conclusions
Multifocal serous retinopathy appears to be a class effect of FGFR inhibitors. FGFR retinopathy clinically resembles MEK retinopathy-both feature multifocal subretinal fluid, low visual significance, and quick resolution. However, given that FGFR inhibitors have a broader molecular range than MEK inhibitors, further characterization of FGFR retinopathy is necessary to generate management guidelines.Type
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Alekseev, Oleg, Effy Ojuok and Scott Cousins (2021). Multifocal serous retinopathy with pemigatinib therapy for metastatic colon adenocarcinoma. International journal of retina and vitreous, 7(1). p. 34. 10.1186/s40942-021-00305-9 Retrieved from https://hdl.handle.net/10161/26128.
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Oleg Alekseev
Dr. Alekseev completed combined MD-PhD training at Drexel University College of Medicine and pursued post-doctoral fellowship training at the University of Pennsylvania School of Medicine. He completed Ophthalmology residency training at the University of North Carolina School of Medicine, where he also served as a chief resident. Dr. Alekseev pursued double-fellowship training in Medical Retina and Inherited Retinal Degenerations at the Duke Eye Center, where he then joined the faculty in 2022.
Dr. Alekseev is a member of the Duke Center for Retinal Degenerations and Ophthalmic Genetic Diseases. His clinical focus is on inherited retinal degenerations, including conditions like retinitis pigmentosa, Stargardt disease, macular pattern dystrophies, syndromic retinal degenerations, and mimickers like autoimmune and iatrogenic retinopathies. Dr. Alekseev’s patients have access to advanced diagnostic modalities, including electrophisiology testing, various types of perimetry testing, specialized retinal imaging, as well as genetic testing. In addition to his practice, Dr. Alekseev conducts clinical trials in rare genetic conditions of the retina, such as choroideremia and retinitis pigmentosa.
As a K08-scholar, Dr. Alekseev dedicates the majority of his time to basic and translational research in the laboratory. He is interested in developing gene-agnostic approaches to extend the longevity of ailing photoreceptors in conditions like retinitis pigmentosa, thereby preserving the vision of affected patients. The approaches he investigates include both gene-therapy and small-molecule-based therapeutic modalities.
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