CHOROIDAL NEOVASCULAR MEMBRANES ASSOCIATED WITH PAPILLITIS IN A PATIENT ON CHECKPOINT INHIBITOR

The purpose of this study was to describe a case of bilateral peripapillary choroidal neovascular membranes in the setting of a patient with papillitis associated with pembrolizumab for Stage IIIA adenocarcinoma of the lung.

This was a retrospective case report with fundus photography, fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography.

A 59-year-old woman with Stage IIIA adenocarcinoma of the lung on pembrolizumab therapy presented with symptoms of blurry vision. She was found to have bilateral papillitis with right eye peripapillary subretinal hemorrhage and serous retinal detachment involving the fovea. Fluorescein angiography suggested peripapillary neovascularization with leakage in both eyes. Intravitreal bevacizumab injections were given in both eyes on a monthly basis with dramatic resolution of subretinal hemorrhage and fluid and control of peripapillary choroidal neovascular membranes.

Pembrolizumab has been associated with many ocular adverse effects, and to the best of our knowledge, we report the first case of pembrolizumab associated with papillitis and peripapillary choroidal neovascular membranes. Control of the neovascularization was achieved with antivascular endothelial growth factor therapy.