Lorlatinib-Induced Blindness: A Rare Entity.

Dincer, Neris; Can, Orcun; Demir, Gokhan; Ozyar, Enis · Pract Radiat Oncol · 2025

case_report · Level V

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Abstract

Lorlatinib is a central nervous system-penetrant third-generation tyrosine kinase inhibitor approved for the first-line management of metastatic non-small cell lung cancer with anaplastic lymphoma kinase rearrangement,<sup>1</sup> which accounts for 3% to 5% of non-small cell lung cancer cases.<sup>2</sup> The most commonly reported side effects include hyperlipidemia, edema, peripheral neuropathy, and central nervous system effects.<sup>2</sup> Whereas ocular side effects such as photopsia, blurred vision, vitreous floaters, and diplopia have been documented with another anaplastic lymphoma kinase-tyrosine kinase inhibitor, crizotinib, there are few reports of such effects with lorlatinib.<sup>3</sup> Herein, we present a case of bilateral optic neuropathy, initially misdiagnosed as optic nerve metastases and treated with palliative radiation therapy.

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