Reversible Macular Lesions in the Setting of Oral Pan-Fibroblast Growth Factor Inhibitor for the Treatment of Bladder Cancer

The tyrosine kinase inhibitor, JNJ-42756493, is an oral pan-fibroblast growth factor receptor inhibitor being studied as an antineoplastic agent. It is currently the subject of a phase II clinical trial for the treatment of urothelial cancer. We report 2 patients who developed visual disturbance shortly after starting or increasing dosage of this medication and were found to have bilateral foveal detachments on ocular coherence tomography imaging. The first patient discontinued this medication and the retinal lesions resolved with a return to baseline vision within 4 to 6 weeks. After restarting the medication at a lower dose, neither visual disturbance nor retinal lesions recurred. In the second patient, lesions were found to greatly improve shortly after discontinuation of the medication but recurred even on a reduced dose regimen.