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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.
Orbit (Amsterdam, Netherlands)
|May 18, 2022
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.
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.
