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Ipilimumab-related orbitopathy: a case report.

Abigail P Jebaraj1, Tyler J Etheridge1, Blair A Winegar2

  • 1Moran Eye Center, University of Utah John A., Salt Lake City, Utah, USA.

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|May 18, 2022
PubMed
Summary

Ipilimumab, an immune checkpoint inhibitor, can cause rare ocular inflammation. This case highlights managing ipilimumab-induced orbital inflammation after rechallenge, differentiating it from thyroid orbitopathy.

Keywords:
Immune checkpoint inhibitorimmune-related adverse eventinflammatory orbitopathyipilimumaborbital inflammation

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Area of Science:

  • Immunology
  • Oncology
  • Ophthalmology

Background:

  • Ipilimumab is an immune checkpoint inhibitor for metastatic melanoma.
  • Immune-related adverse events (irAEs) are known side effects.
  • Ocular inflammation is a rare but potential irAE.

Observation:

  • A 54-year-old man with metastatic melanoma experienced bilateral orbital inflammation.
  • This occurred after ipilimumab rechallenge, 6 years after initial ocular inflammation with the drug.
  • Imaging revealed tendon-involving myositis.

Findings:

  • The patient was treated with intravenous corticosteroids and immunoglobulin therapy.
  • This management led to improvement in the orbital inflammation.
  • The case underscores ipilimumab's potential ocular toxicity.

Implications:

  • Distinguishing ipilimumab-associated orbital inflammation from thyroid orbitopathy is crucial.
  • Effective management strategies are needed to mitigate ocular irAEs.
  • This case informs clinical practice regarding ipilimumab use and monitoring.