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Ocular Adverse Events following Use of Immune Checkpoint Inhibitors for Metastatic Malignancies

Carl W Noble1, Sapna S Gangaputra2, Ian A Thompson3

  • 1Department of Ophthalmology, George Washington University , Washington DC, USA.

Ocular Immunology and Inflammation
|April 24, 2019
PubMed
Abstract

Insights

Immune checkpoint inhibitors can cause various ocular immune-related adverse events (irAEs), ranging from dry eye to severe inflammation. Most cases were managed with corticosteroids, allowing patients to continue cancer treatment.

Area of Science:

  • Ophthalmology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are revolutionizing cancer treatment.
  • Ocular immune-related adverse events (irAEs) are a potential complication of ICI therapy.
  • Understanding the spectrum and management of ocular irAEs is crucial for patient care.

Purpose of the Study:

  • To characterize the clinical features, severity, and management strategies for ocular irAEs.
  • To investigate the impact of ocular irAEs on ongoing cancer therapy.

Main Methods:

  • Retrospective chart review of patients treated with ICIs between 2000 and 2017.
  • Analysis of clinical data from three tertiary ophthalmology clinics.
  • Identification of patients with new-onset ocular symptoms during ICI therapy.

Main Results:

  • Eleven patients with ocular irAEs were identified.
  • Ocular irAEs presented with a wide range of conditions, including keratoconjunctivitis sicca and Vogt-Koyanagi-Harada-like findings.
  • Average onset of ocular irAEs was 15.7 weeks after starting ICI therapy.
  • Corticosteroids effectively managed ocular inflammation in most patients.
  • Three patients discontinued treatment due to ocular irAEs impacting visual acuity.

Conclusions:

  • Immune checkpoint inhibitors are associated with a diverse spectrum of ocular irAEs.
  • Ocular irAEs generally do not necessitate discontinuation of cancer treatment.
  • Prompt diagnosis and management of ocular irAEs are important for preserving vision and enabling continued oncologic care.
Keywords:
Adversecheckpointeventsinflammationinhibitor

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