How do you manage MEK inhibitor induced ocular adverse events?

MEK inhibitor associated ocular adverse events may range from subretinal fluid, which does not typically require medication cessation to uveitis, which is treated according to the level of inflammation. In one report of optical coherence tomography scan evaluations to image retinal structures following MEK inhibitor use, a high rate of subretinal fluid was observed (i.e., 46 of 51 participants; Weber et al., PMID 27309887). These pockets of subretinal fluid were transient and did not require treatment cessation. Uveitis may range from mild, anterior uveitis, which can be treated with topical corticosteroids to panuveitis (i.e., involving all tissue layers of the eye), which may require oral corticosteroids or periocular steroids depending on the degree of inflammation. While reports of ocular AEs associated with MEK inhibitors appears to be low (i.e., ranging from 1-2% in the literature), ophthalmic symptoms that should prompt a formal ophthalmologic consultation include visual acuity changes, red eye, photophobia, or eye pain.