Immune checkpoint inhibitor-associated bilateral optic neuritis.

Area of Science:

• Oncology
• Immunology
• Neuro-ophthalmology

Background:

• Immune checkpoint inhibitors (ICIs) are increasingly used for cancer treatment.
• Immune-related adverse events (irAEs) are potential complications of ICI therapy.
• Optic neuritis is a rare but serious irAE associated with ICIs, potentially leading to vision loss.

Purpose of the Study:

• To report a case of optic neuritis in a patient treated with nivolumab.
• To highlight the importance of early recognition and management of ICI-induced optic neuritis.

Main Methods:

• Case report of an elderly woman with metastatic malignant melanoma.
• Treatment with nivolumab (a programmed cell death protein 1 inhibitor).
• Monitoring for adverse events, including visual changes.

Main Results:

• The patient developed bilateral, painless vision loss after 2 months of nivolumab treatment.
• Diagnosis of optic neuritis confirmed as an irAE.
• Patient received treatment based on expert opinion for similar conditions.

Conclusions:

• Optic neuritis is an emerging irAE with the expanded use of ICIs.
• Prompt diagnosis and intervention, potentially with corticosteroids or plasma exchange, are crucial for preserving vision.
• Increased vigilance for optic neuritis in patients receiving ICIs is warranted.