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Retinal Vasculitis Associated with Ipilimumab.

Edmund Tsui1,2, John A Gonzales1,2

  • 1F.I. Proctor Foundation, University of California , San Francisco, California, USA.

Ocular Immunology and Inflammation
|July 18, 2019
PubMed
Summary
This summary is machine-generated.

This case report details retinal vasculitis, an ocular side effect, in a patient treated with ipilimumab (a type of immune checkpoint inhibitor). Treatment with corticosteroids and a dexamethasone implant resolved the condition.

Keywords:
Immune checkpoint inhibitorimmunotherapyipilimumabuveitisvasculitis

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Area of Science:

  • Ophthalmology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors like ipilimumab are crucial in cancer therapy.
  • These therapies can cause immune-related adverse events (irAEs), including ocular manifestations.
  • Retinal vasculitis is a rare but serious ocular irAE.

Observation:

  • A patient with chronic myeloid leukemia developed anterior uveitis during ipilimumab therapy.
  • After initial treatment, visual acuity decreased, and optical coherence tomography revealed cystoid macular edema.
  • Fluorescein angiography showed diffuse capillary leakage, indicative of retinal vasculitis.

Findings:

  • The patient experienced recurrent retinal vasculitis despite topical corticosteroids and oral prednisone.
  • An intravitreal dexamethasone implant successfully resolved the macular edema and vasculitis.
  • This case highlights the potential for delayed-onset ocular irAEs with ipilimumab.

Implications:

  • The findings expand the known spectrum of ocular irAEs associated with immune checkpoint inhibitors.
  • Ophthalmologists should consider ipilimumab as a potential cause of retinal vasculitis in patients undergoing immunotherapy.
  • Prompt diagnosis and multimodal treatment are essential for managing ocular irAEs and preserving vision.