A case of severe recurrent VKH-like uveitis following BRAF/MEK inhibitor therapy: a case report and review of the literature

BRAF and MEK inhibitors are increasingly used as targeted anticancer therapies. However, they are associated with vision-threatening ocular toxicities. We present the case of a 68-year-old woman who developed severe, recurrent VKH-like uveitis that progressed despite corticosteroid therapy and a reduced-dose drug rechallenge. The constellation of findings, including bilateral panuveitis, exudative retinal detachments, diffuse choroidal thickening, subsequent sunset-glow fundus changes, retinal pigment epithelium clumping, a negative inflammatory and infectious workup, improvement following drug withdrawal, and recurrence after medication rechallenge, supported the diagnosis of VKH-like uveitis secondary to dabrafenib and trametinib. Although some patients may be successfully managed with corticosteroids and treatment modification, our case demonstrates that recurrent VKH-like inflammation can progress despite aggressive local and systemic immunosuppression and cancer treatment adjustments. Given the increasing number of reported cases and the high incidence and hazard ratios observed in recent studies, development of formal management guidelines should be considered.