Neuro-ophthalmic Complications of Immune-Checkpoint Inhibitors

Area of Science:

• Oncology
• Immunology
• Neurology

Background:

• Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by enhancing immune responses against malignancies.
• Three main classes of ICIs exist: anti-cytotoxic T-lymphocyte associated antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1), and anti-programmed cell death ligand-1 (PD-L1).
• Physicians must be aware of potential complications in patients with a history of malignancy and ICI exposure.

Purpose of the Study:

• To review the most common immune-related adverse events (irAEs) affecting the central and peripheral nervous systems following ICI therapy.
• To discuss neuro-ophthalmic manifestations associated with these irAEs.

Main Methods:

• This is a review article.
• Literature search on ICI-related neurological and neuro-ophthalmic adverse events.

Main Results:

• ICI therapy can lead to various immune-related adverse events affecting the nervous system.
• Neuro-ophthalmic complications, both afferent and efferent, are potential manifestations of these irAEs.

Conclusions:

• Early identification and prompt treatment of neurological irAEs are essential.
• Discontinuation of the implicated ICI is a critical step in managing these adverse events.
• Timely intervention can prevent significant patient morbidity and mortality.