As new chemotherapy agents emerge, ophthalmologists may play a role in identifying vision-threatening adverse effects. Inherited retinal degenerations can offer insight into the changes that may result from pharmacologic inhibition of the signaling pathways involved in these conditions. To present a case of a patient treated with a yes-associated protein (YAP)/transcriptional enhancer activator domain (TEAD) inhibitor who developed chorioretinal findings that resemble those seen in helicoid peripapillary chorioretinal degeneration (HPCD, also known as Sveinsson chorioretinal atrophy), an autosomal dominant disease caused by loss-of-function variants in TEAD1. Case report of a single patient at a large university hospital. The patient was treated with VT3989, a YAP/TEAD inhibitor, for 5 cycles. Clinical evaluation and description of the ocular condition via fundus photography and fundus autofluorescence. A woman in her 50s with metastatic mesothelioma diagnosed several years previously presented for evaluation. Nine months before presentation, she had undergone several cycles of treatment with chemotherapy agent VT3989, which inhibits the interaction of the YAP and TEAD proteins that form the terminal transcriptional effector complex of the Hippo pathway, which is involved in control of cell fate, proliferation, apoptosis, and tissue regeneration. She developed visual decline associated with radially oriented areas of retinal pigment epithelium atrophy extending around both optic nerves, along with small scattered atrophic flecks elsewhere. Given the atypical nature of the peripapillary findings and the resemblance to a mild form of HPCD, which is caused by loss-of-function variants in TEAD1, these changes were presumed to be secondary to treatment with the YAP/TEAD inhibitor VT3989. Downregulation of the Hippo signaling pathway via YAP/TEAD inhibition in an adult patient may result in a phenotype resembling a mild form of HPCD (Sveinsson chorioretinal atrophy), underscoring the importance of this pathway in maintenance of the adult retina and retinal pigment epithelium. As novel cancer therapeutics continue to emerge, it may be important to ensure ophthalmologic monitoring of patients on drugs targeting the Hippo pathway.

Helicoid peripapillary chorioretinal degeneration (HPCD) is a hereditary disease of the fundus that is characterized by atrophic chorioretinal areas that appear early in life and expand gradually from the optic disc towards the macula and the periphery. We describe the case of an elderly man with a known diagnosis of HPCD who developed choroidal neovascular membrane (CNV) in both eyes during the course of the disease. The patient was treated with intravitreal injection of ranibizumab, to which he had excellent response. The CNV subsided with 2 injections in the right eye and 1 in the left. Two years after the initial diagnosis of CNV in the right eye, visual acuity was 5/10 OD and 9/10 OS. Helicoid peripapillary chorioretinal degeneration is rarely complicated by CNV as the fundus lacks the trigger factors that would sustain this process. Although rare, HPCD complicated by CNV can be seen bilaterally, but responds well to few ranibizumab injections.