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Checkpoint inhibitor-induced sarcoid choroidal granulomas
Cindy Ung1, Evangelos Gragoudas1
1Massachusetts Eye and Ear, Department of Ophthalmology, Retina Service, Harvard Medical School, Boston, MA, USA.
American Journal of Ophthalmology Case Reports
|March 21, 2020
Summary
Nivolumab therapy for melanoma can cause sarcoid choroidal granulomas. This immune-related adverse event presents as bilateral choroidal lesions and requires clinical awareness.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Nivolumab, an immune checkpoint inhibitor, is increasingly used for metastatic cutaneous melanoma.
- Immune-related adverse events (irAEs) are known complications of immune checkpoint inhibitor therapy.
Observation:
- A 55-year-old male with metastatic melanoma developed bilateral creamy, yellow choroidal lesions after nivolumab treatment.
- Ophthalmologic examination showed no signs of ocular inflammation.
- Systemic evaluation revealed pulmonary sarcoidosis confirmed by biopsy.
Findings:
- The case presents novel sarcoid choroidal granulomas as a potential irAE of nivolumab.
- This finding links nivolumab therapy to specific ocular manifestations of sarcoidosis.
Implications:
- Clinicians should consider sarcoid choroidal granulomas in patients on nivolumab presenting with visual changes.
- Awareness of this irAE is crucial for timely diagnosis and management in melanoma patients receiving immunotherapy.
