FAILED LASER RETINOPEXY IN A PATIENT UNDERGOING PAZOPANIB THERAPY. Issue Volume 15:Issues 6(2021) (November 2021)

• Record Type: Journal Article
• Authors: Lifton, Jacob; Chow, Audrey; Moshfeghi, Andrew A.
• Is Part Of: Retinal cases & brief reports. Volume 15:Issues 6(2021)
• Publication Date: 2021-11
• Subjects: laser photocoagulation -- pazopanib -- retinal detachment -- retinal remodeling -- retinopexy -- wound healing -- scar formation; Retina -- Diseases -- Periodicals; Retina -- Periodicals; Retinal Diseases -- Periodicals; Retina -- Case Reports; Retinal Diseases -- Case Reports; 617.7
• DOI: 10.1097/ICB.0000000000000877
• Languages: English
• ISSNs: 1935-1089

Abstract

Abstract : Purpose: To report a case of failed endolaser retinopexy in patient taking pazopanib and possible association with impaired retinal remodeling. Methods: Case report. Results: A 68-year-old man with a history of radiation-induced high-grade metastatic mediastinal leiomyosarcoma, on pazopanib 600 mg daily, presented with a superior retinal tear 2 months after initiating pazopanib. The patient was treated with pars plana vitrectomy and endolaser retinopexy without any immediate complications. One month postoperatively, the patient was found to have a new superior macula-sparing rhegmatogenous retinal detachment extending through the laser barricade nasally. A large proportion of the laser lesions in this area had notably remained chalk-white. The patient underwent pars plana vitrectomy with scleral buckling, and repeat endolaser retinopexy. Pazopanib therapy was stopped 1 week later in consultation with the oncology team and was reinitiated after the retina seemed stable under silicone oil for several weeks. The scars from the patient's repeat endolaser retinopexy remained pale white at his clinic visit 2 months after the procedure, and at that time, his initial laser scars had only just begun to darken with pigment. Four and a half months after the initial vitrectomy and endolaser retinopexy, and three and a half months after his repeat vitrectomy and endolaser retinopexy, all the patient's laser scars have developed increased pigment, and his retina remains completely flat under silicone oil tamponade. Conclusion: Pazopanib may have had an adverse effect on retinal wound healing after vitrectomy with endolaser retinopexy, leading to persistence of pale laser lesions many weeks after laser application. It is possible that this may have impaired the typical development of chorioretinal laser scar formation and led to subsequent retinal detachment. Abstract : A 68-year-old man presented with a vitreous hemorrhage due to a horseshoe retinal tear with an avulsed bridging vessel while taking pazopanib for metastatic leiomyosarcoma. One month after treatment with vitrectomy and endolaser retinopexy, he developed a rhegmatogenous retinal detachment emanating from the original horseshoe tear and extending through the previous laser barricade scars, which remained chalk-white in clinical appearance. Pazopanib may have adversely affected retinal remodeling, leading to impaired scar formation and failed endolaser retinopexy.