Ocular adverse events associated with immune checkpoint inhibitors: a novel multidisciplinary management algorithm

Area of Science:

• Ophthalmology
• Oncology
• Immunology

Background:

• Checkpoint inhibitors (CPIs) are crucial cancer therapeutics.
• Ocular immune-related adverse events (IrAEs) are rare complications of CPIs, affecting ~1% of patients.
• Prompt recognition and intervention are vital to prevent permanent vision loss.

Purpose of the Study:

• To present a case series of ocular IrAEs managed at a single institution.
• To identify common ocular IrAEs associated with CPIs.
• To develop a clinical algorithm for managing ocular IrAEs and provide treatment recommendations.

Main Methods:

• Retrospective case series of eight patients treated with CPIs who developed ocular IrAEs.
• Review of existing literature and international guidelines.
• Development of a management algorithm based on clinical experience and published data.

Main Results:

• Anterior uveitis was the most frequent ocular IrAE requiring intervention.
• Local interventions were effective in managing ocular IrAEs.
• The proposed algorithm aims to guide efficient clinical management.

Conclusions:

• Ocular IrAEs, particularly anterior uveitis, necessitate prompt and specialized management.
• Local treatment strategies can be effective, potentially avoiding systemic corticosteroids.
• A structured approach, like the proposed algorithm, can aid clinicians in managing patients on CPI therapy experiencing ocular symptoms.