Related Experiment Video
Updated: Jun 6, 2025
Author Spotlight: A Novel Protocol for Intracameral Injections to Enhance Precision in Rodent Ophthalmology
Published on: May 31, 2024
Emerging Ocular Side Effects of Immune Checkpoint Inhibitors: A Comprehensive Review
Kevin Y Wu1, Yoel Yakobi2, Diana D Gueorguieva3
1Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada.
Abstract:
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, offering significant improvements in patient survival across various malignancies. However, their use is associated with a broad spectrum of immune-related adverse events (irAEs), including those affecting the eye and its surrounding structures, collectively termed ocular irAEs (OirAEs). Although rare, OirAEs (e.g., keratitis, uveitis, retinal vasculitis, etc.) can significantly impact a patient's quality of life, leading to ocular complications if left untreated. This review provides a comprehensive overview of OirAEs associated with ICIs, including their clinical manifestations, underlying mechanisms, and current management strategies. We delve into the anterior and posterior segment adverse events, highlighting conditions such as dry eye, uveitis, and retinal disorders, as well as neuro-ophthalmic and orbital complications. Furthermore, we discuss the challenges in diagnosing and treating these conditions, particularly given the overlap with other autoimmune and paraneoplastic syndromes. Finally, we identify key knowledge gaps and suggest future research directions aimed at optimizing the management of OirAEs while maintaining the efficacy of cancer therapy. This review underscores the need for increased awareness among clinicians to prevent irreversible ocular damage and enhance patient outcomes.
Insights
Immune checkpoint inhibitors (ICIs) can cause rare ocular immune-related adverse events (OirAEs) affecting vision. Early recognition and management are crucial to prevent permanent eye damage and maintain cancer treatment efficacy.
Area of Science:
- Oncology
- Ophthalmology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, improving survival rates.
- However, ICIs can induce immune-related adverse events (irAEs), including ocular irAEs (OirAEs).
- OirAEs, though infrequent, pose risks of significant visual impairment and reduced quality of life.
Purpose of the Study:
- To provide a comprehensive review of OirAEs associated with ICIs.
- To detail clinical manifestations, pathogenic mechanisms, and current management strategies for OirAEs.
- To highlight challenges in diagnosis and suggest future research directions.
Main Methods:
- Systematic literature review of OirAEs linked to ICI therapy.
- Analysis of clinical presentations, including anterior and posterior segment disorders.
- Discussion of diagnostic challenges and treatment approaches.
Main Results:
- OirAEs encompass a range of conditions like keratitis, uveitis, and retinal vasculitis.
- Management requires careful consideration due to potential overlap with other autoimmune conditions.
- Effective strategies are needed to balance cancer treatment efficacy with ocular health.
Conclusions:
- Increased clinician awareness of OirAEs is essential for timely diagnosis and intervention.
- Addressing knowledge gaps in OirAEs management is critical to prevent irreversible ocular damage.
- Optimizing OirAEs care can enhance patient outcomes in ICI-treated cancer patients.
Related Concept Videos
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:25Glaucoma: Overview
01:28Angle Closure Glaucoma: Treatment