Multimodal imaging in a case of acute erdafitinib-induced maculopathy

Introduction: To analyze multimodal imaging findings in a patient with erdafitinib-induced maculopathy. Case Report: An 80-year-old male presented to our retina clinic with decreased vision in his left eye that began two weeks prior to his most recent visit. His past ocular history included epiretinal membranes in both eyes. He had been diagnosed with bladder cancer and had been undergoing aggressive chemotherapy, which was discontinued two months prior to this visit due to serious adverse effects. One month before the most recent visit, his oncologist had initiated treatment with erdafitinib. His best corrected visual acuity was 20/50 in the right eye and 20/100 in the left eye. Fundus examination revealed macular pucker, mild diabetic retinopathy, and mild hypertensive retinopathy in both eyes. Optical coherence tomography imaging of the macula showed new onset subretinal fluid in both eyes. Fluorescein angiography and indocyanine green angiography of the retina and choroid did not show any abnormalities explaining the subretinal fluid. Conclusion: Erdafitinib can cause toxic maculopathy with subretinal fluid on optical coherence tomography of the retina with no abnormalities on fluorescein angiography and indocyanine green angiography.