Ponatinib Inducing a Panuveitis with Choroidal Effusions and Neurosensory Retinal Detachment in a Patient with Chronic Myeloid Leukaemia

Ocul Immunol Inflamm. 2022 Jul;30(5):1186-1189. doi: 10.1080/09273948.2020.1866618. Epub 2021 Mar 4.

Abstract

Case summary: We present the case of a 50 year old male patient being treated for chronic myeloid leukemia by the tyrosine kinase inhibitor, Ponatinib. After 3 months of treatment, he developed a sight-threatening granulomatous panuveitis in both eyes, with choroidal effusions and neurosensory retinal detachments. Except for a positive interferon-gamma release assay suggesting previous Tuberculosis exposure, all uveitis investigations were normal. Discontinuation of the suspected causative drug led to resolution of signs and a consequent improvement in visual acuity.

Conclusion: Ponatinib use may be associated with with a uveitic phenotype that is reminiscent of Harada's disease. We compare and contrast this rare ocular phenomenon with Vogt-Koyanagi-Harada syndrome and discuss a possible immunological basis.

Keywords: Ponatinib; Vogt-Koyanagi-Harada syndrome; choroidal effusion; chronic myeloid leukemia; neurosensory retinal detachment.

Publication types

  • Case Reports

MeSH terms

  • Choroidal Effusions*
  • Humans
  • Imidazoles
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / complications
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Male
  • Panuveitis* / chemically induced
  • Panuveitis* / diagnosis
  • Panuveitis* / drug therapy
  • Protein Kinase Inhibitors / therapeutic use
  • Pyridazines
  • Retinal Detachment* / chemically induced
  • Retinal Detachment* / diagnosis
  • Retinal Detachment* / drug therapy
  • Uveitis* / complications
  • Uveomeningoencephalitic Syndrome* / diagnosis

Substances

  • Imidazoles
  • Protein Kinase Inhibitors
  • Pyridazines
  • ponatinib