Neuro-Ophthalmic Complications of Immune Checkpoint Inhibitors

Neuro-ophthalmic complications associated with immune checkpoint inhibitors (ICIs) are rare. These involve adverse events primarily affecting the optic nerve, other cranial nerves, and the neuromuscular junction. Myasthenia gravis-like syndrome (often with concomitant myositis) is the most commonly reported immune-related adverse event, followed by optic neuropathy, of which the most notable is optic neuritis. Symptoms typically present within 6 months of exposure. Prompt and comprehensive evaluation is essential. Diagnostic work-up may include MRI brain and orbits, lumbar puncture, serum, and cerebrospinal fluid antibody testing.