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Title

Angio-Optical coherence tomography in patients after MEK-inhibitor therapy for cutaneous melanoma.

Purpose	Evaluation by angio-OCT of blood flow parameters in different retinal layers in patients who received MEK-inhibitor therapy.
Methods	Single center, prospective cohort study of 22 eyes of 11 patients. All patients had been treated with 2mg Trametinib q.d. (a MEK-inhibitor) for stage IV cutaneous melanoma, progressive under nivolumab/ ipilimumab. The mean age of the patients at the start of the treatment was 61,5 years [30,4-77,4]. Before the start of treatment and every 6 weeks during a follow up of 6 months, patients underwent a complete ophthalmologic exam, containing fundus pictures, OCT, angio-OCT and fluorescein angiography (FA).
Results	Within 1 month after start of the treatment OCT in 4 eyes of 2 patients showed serous retinal detachments in the foveal region similar to what is observed in central serous chorioretinopathy (CSC). During the follow up of these 2 patients FA didn’t show any leakage in the area of detachment and angio-OCT didn’t reveal any alteration in flow signal parameters in the different retinal layers and choriocapillaris either.
Conclusion	4 eyes (18% of all examined eyes) showed ocular complications during MEK-inhibitor therapy. In these patients angio-OCT didn’t reveal any difference of the retinal and coriocoapillaris blood flow parameters like these observed in CSC. Therefore, the present results may suggest a possible toxicity of trametinib towards RPE cells and the outer blood-retinal barrier.
Conflict of interest	No

Authors 1

Last name	FASOLINO
Initials	G
Department	Universitair Ziekenhuis Brussel
City	Brussel

Authors 2

Last name	Awada
Initials	G
Department	Universitair Ziekenhuis Brussel
City	Brussel

Authors 3

Last name	Koulalis
Initials	J
Department	Universitair Ziekenhuis Brussel
City	Brussel

Authors 4

Last name	Verhelst
Initials	B
Department	Universitair Ziekenhuis Brussel
City	Brussel

Authors 5

Last name	Ten Tusscher
Initials	M
Department	Universitair Ziekenhuis Brussel
City	Brussel