Patients with known history or current evidence of retinal vein occlusion (RVO) are not eligible:* History of RVO, or predisposing factors to RVO (e.g. uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes)* Visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO such as:** Evidence of new optic disc cupping** Evidence of new visual field defects** Intraocular pressure > 21 mmHg** NOTE: Ophthalmic exam is required for all patients; exam must be obtained within 28 days prior to registration
History or current evidence/risk of retinal vein occlusion (RVO)
Ophthalmologic conditions:* Current or past history of central serous retinopathy* Current or past history of retinal vein occlusion* Known intraocular pressure (IOP) > 21 mmHg (or ULN adjusted by age) or uncontrolled glaucoma (irrespective of IOP); patients with known glaucoma and increased IOP who do not have meaningful vision (light perception only or no light perception) and are not experiencing pain related to the glaucoma may be eligible after discussion with the study chair* Subjects with any other significant abnormality on ophthalmic examination should be discussed with the study chair for potential eligibility* Ophthalmological findings secondary to long-standing optic pathway glioma (such as visual loss, optic nerve pallor or strabismus) or long-standing orbito-temporal PN (such as visual loss, strabismus) will NOT be considered a significant abnormality for the purposes of the study
TREATMENT: Patients with a history or current evidence/risk of retinal vein occlusion (RVO) or retinal pigment epithelial detachment (RPED) or predisposing factors to RVO or RPED (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes), are ineligible to receive treatment with trametinib DMSO; visible retinal pathology (as assessed by ophthalmic exam) that is considered a risk factor for RVO or RPED includes evidence of new optic disc cupping or new visual field defects, or intraocular pressure > 21 mm Hg
History of retinal vein occlusion (RVO)
History or current evidence/risk of retinal vein occlusion (RVO) or central serous retinopathy (CSR):* History of RVO or CSR, or predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes)* Visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO or CSR such as evidence of new optic disc cupping, evidence of new visual field defects, and intraocular pressure > 21 mmHg
History or current evidence/risk of retinal vein occlusion (RVO)
History or current evidence/risk of retinal vein occlusion (RVO)
History or current evidence/risk of retinal vein occlusion (RVO) or retinal pigment epithelial detachment (RPED):* History of RVO or RPED, or predisposing factors to RVO or RPED (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes)* Visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO or RPED such as evidence of new optic disc cupping, evidence of new visual field defects, and intraocular pressure > 21 mm mercury (Hg)
Patients with a history or current evidence/risk of retinal vein occlusion (RVO)
Patients with known optic nerve and/or retinal involvement are not eligible; patients who are presenting with visual disturbances should have an ophthalmologic exam and, if indicated, a magnetic resonance imaging (MRI) to determine optic nerve or retinal involvement
Patients with the following ophthalmological findings/conditions:* Intraocular pressure > 21 mmHg, or uncontrolled glaucoma (irrespective of intraocular pressure)* Current or past history of central serious retinopathy or retinal vein occlusion
Patients with known history or current evidence of retinal vein occlusion (RVO) or central serous retinopathy (CSR) are not eligible:* History of RVO or CSR, or predisposing factors to RVO or CSR (e.g. uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes)* Visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO or CSR such as:** Evidence of new optic disc cupping** Evidence of new visual field defects** Intraocular pressure > 21 mmHg* NOTE: ophthalmic exam is required for all patients; exam must be obtained within 28 days prior to registration
Patients must not have history of retinal vein occlusion (RVO)
History of retinal vein occlusion (RVO)
Central serous retinopathy (CSR) including presence of predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled diabetes mellitus, or a history of hyperviscosity or hypercoagulability syndromes); or visible pathology (e.g., evidence of optic disc cupping, evidence of new visual field defects on automated perimetry, or intraocular pressure > 21 mmHg as measured by tonography) as assessed by ophthalmic examination
Known ophthalmologic conditions, such as:* Current or past history of central serous retinopathy* Current or past history of retinal vein occlusion* Known intraocular pressure (IOP) > 21 mmHg (or ULN adjusted by age) or uncontrolled glaucoma (irrespective of IOP); patients with known glaucoma and increased IOP who do not have meaningful vision (light perception only or no light perception) and are not experiencing pain related to the glaucoma, may be eligible after discussion with the study chair* Subjects with any other significant abnormality on ophthalmic examination should be discussed with the study chair for potential eligibility* Ophthalmological findings secondary to long-standing optic pathway glioma (such as visual loss, optic nerve pallor or strabismus) or long-standing orbito-temporal PN (such as visual loss, strabismus) will NOT be considered a significant abnormality for the purposes of the study
Patients with pre-existing retinal disease on ophthalmologic exam will be excluded
CLINICAL/LABORATORY CRITERIA: Patients must not have untreated or unresolved retinopathy or have a history (or current evidence) of retinal vein occlusion determined by an ophthalmology exam within 42 days prior to registration
Known ophthalmologic conditions, such as:* Current or past history of retinal pigment epithelial detachment (RPED)/central serous retinopathy (CSR)* Current or past history of retinal vein occlusion* Known intraocular pressure (IOP) > 21 mmHg (or ULN adjusted by age) or uncontrolled glaucoma (irrespective of IOP); patients with controlled glaucoma and increased IOP who do not have meaningful vision (light perception only or no light perception) may be eligible after discussion with the study chair* Subjects with any other significant abnormality on ophthalmic examination (performed by an ophthalmologist) should be discussed with the study chair for potential eligibility * Ophthalmological findings secondary to long-standing optic pathway glioma (such as visual loss, optic nerve pallor or strabismus) or long-standing orbito-temporal PN (such as visual loss, strabismus) will NOT be considered a significant abnormality for the purposes of the study
Ophthalmological conditions as follows:* Current or past history of retinal pigment epithelial detachment (RPED)/central serous retinopathy (CSR) or retinal vein occlusion* Intraocular pressure (IOP) > 21 mmHg or uncontrolled glaucoma (irrespective of IOP)* Evidence of optic glioma, malignant glioma, malignant peripheral nerve sheath tumor,* Ophthalmological findings secondary to long-standing optic pathway glioma (such as visual loss, optic nerve pallor or strabismus) or long-standing orbito-temporal PN (such as visual loss, strabismus) will NOT be considered a significant abnormality for the purposes of the study* Subjects with any other significant abnormality on ophthalmic examination (performed by an ophthalmologist) should be discussed with the study chair for potential eligibility
Patients with active optic nerve and/or retinal involvement are not eligible; patients who are presenting with visual disturbances should have an ophthalmologic exam and, if indicated, a magnetic resonance imaging (MRI) to assess optic nerve or retinal involvement
History or current evidence/risk of retinal vein occlusion (RVO)
Patients with known significant ophthalmologic conditions (uncontrolled glaucoma, history of retinal vein occlusion or retinal detachment, excluding patients with longstanding findings secondary to existing conditions) are not eligible