CANCER-ASSOCIATED RETINOPATHY AFTER CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY

Area of Science:

• Ophthalmology
• Oncology
• Immunology

Background:

• Chimeric antigen receptor T (CART)-cell therapy is a novel cancer treatment.
• Cancer-associated retinopathy (CAR) is an autoimmune disorder affecting photoreceptors.

Purpose of the Study:

• To report a case of CAR occurring shortly after CART-cell therapy.
• To investigate the potential mechanisms of CAR in this context.

Main Methods:

• Retrospective case report.
• Clinical examination, multimodal imaging (fluorescein angiography, optical coherence tomography), electroretinography, and immunoserological testing (Western blot, immunohistochemistry) were performed.

Main Results:

• A patient with follicular lymphoma developed rapid vision loss post-CART therapy.
• Ocular findings included peripheral vascular attenuation, ellipsoid zone loss, and abnormal electroretinography.
• Positive antienolase and anti-heat shock protein 60 antibodies were detected.

Conclusions:

• CAR can manifest immediately following CART-cell therapy.
• The B-cell depletion associated with CART therapy may influence CAR pathogenesis.
• CAR pathophysiology might involve mechanisms beyond solely autoantibody-mediated processes.