Mortality and Cancer Response in Patients with Immune Check Point Inhibitor Associated Uveitis

To evaluate mortality and cancer response in oncology patients who developed secondary uveitis during treatment with immune checkpoint inhibitors (ICI).

Single-center retrospective case series of patients with all-cause metastatic cancer who developed secondary treatment-related uveitis between 2016 and 2024 versus age- and cancer-matched control.

Of 3000 screened oncology patients being treated with ICI therapy for metastatic disease, 28 patients who developed secondary uveitis were identified. The median time from ICI initiation and uveitis diagnosis was 124 days. Quiescence was achieved in 86% of cases at mean time 117 ± 112 days after diagnosis. Immunotherapy was paused during the course of uveitis treatment in a total of 22 (79%) cases, of which the cessation was attributable to uveitis alone in 17 (77%) cases. ICI treatment was resumed in 11 of these cases following control of uveitis. Visual acuity was improved or stable in 60% eyes with only 2 patients having worse than 20/400 in one eye. Compared to age‑matched controls, patients who developed secondary uveitis achieved greater rate of positive or desired cancer response (75% vs 50%, p = 0.03). Mortality rate in the uveitis group was lower (29%) compared to age‑matched controls (46%) (p = 0.17). Mean survival time from date of diagnosis was 160 ± 19 in the uveitis group compared to 124 ± 20 months in the non-uveitis group (p = 0.35).

More favorable outcomes were observed in patients who developed secondary uveitis from immune checkpoint therapy.