Neuro-Ophthalmic Complications of Immune Checkpoint Inhibitors.

Area of Science:

• Neuroscience
• Ophthalmology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are increasingly used in cancer therapy.
• Neuro-ophthalmic complications are rare but serious adverse events associated with ICIs.
• These complications can affect the optic nerve, cranial nerves, and neuromuscular junction.

Purpose of the Study:

• To summarize the neuro-ophthalmic complications associated with immune checkpoint inhibitors.
• To highlight the most common presentations and diagnostic approaches.

Main Methods:

• Review of literature on ICI-associated neuro-ophthalmic events.
• Analysis of reported cases focusing on affected structures and clinical presentation.
• Summary of diagnostic work-up protocols.

Main Results:

• The most common ICI-related neuro-ophthalmic adverse event is myasthenia gravis-like syndrome, often with myositis.
• Optic neuropathy, particularly optic neuritis, is another significant complication.
• Symptoms typically manifest within six months of initiating ICI therapy.

Conclusions:

• Neuro-ophthalmic complications from ICIs, though rare, necessitate prompt and thorough evaluation.
• Diagnostic work-up should include neuroimaging (MRI), lumbar puncture, and antibody testing.
• Early recognition and management are crucial for patient outcomes.