Bilateral Papillitis and Unilateral Central Serous Retinopathy Associated with Dabrafenib and Trametinib Use in Metastatic Cutaneous Melanoma

Targeted BRAF/MEK inhibitor therapies have improved survival outcomes for patients with BRAF V600-positive cutaneous melanoma. However, rare neuro-ophthalmic complications attributed to these therapies warrant heightened clinical vigilance. We describe a distinct case of bilateral optic disc oedema and unilateral central serous chorioretinopathy induced by dabrafenib and trametinib in a 79-year-old male undergoing treatment for metastatic cutaneous melanoma. Three months after starting BRAF/MEK inhibitor therapy, the patient developed progressive, painless central vision loss OD and transient blurry vision OS. Clinical examination excluded uveitis and conditions such as Vogt-Koyanagi Harada syndrome, while contrast-enhanced magnetic resonance imaging revealed no optic nerve or chiasm abnormalities. Following prompt discontinuation of dabrafenib and trametinib, along with the initiation of oral prednisone, the patient's visual acuity significantly improved over three weeks, accompanied by resolution of optic disc oedema. At two months of follow-up, visual acuity remained stable, with complete resolution of optic disc oedema and no symptom recurrence. This case emphasises the importance of early recognition, prompt drug discontinuation, and timely corticosteroid administration to optimise visual prognosis in this setting.