对免疫检查点抑制剂的眼科免疫相关不良事件的共识疾病定义
Eileen L Chang1,2, Renee Liu1, Kiandokht Keyhanian1,3
1Department of Ophthalmology, Mass Eye and Ear, Boston, Massachusetts, USA.
Journal for immunotherapy of cancer
|April 8, 2025
概括
为改善治疗和研究,制定了眼科免疫相关不良事件 (Eye-irAEs) 的标准化定义. 本共识指南涉及由免疫检查点抑制剂引起的各种神经眼科和脑膜炎疾病.
科学领域:
- 眼科医生 眼科 眼科
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以导致视力威胁的眼科免疫相关不良事件 (Eye-irAEs).
- 缺少对Eye-irAEs的标准化定义,阻碍了基于证据的治疗开发和翻译研究.
- 眼部IRAE需要明确的诊断标准才能有效管理.
研究的目的:
- 制定共识指导和标准化定义的眼睛-irAEs.
- 建立诊断和分类与ICI相关的眼部疾病的框架.
- 为了促进一致的 Eye-irAEs 的临床管理和研究.
主要方法:
- 一个经过修改的Delphi共识过程,涉及来自25个学术中心的29名眼科专家.
- 多学科小组分为神经眼科/眼道疾病和眼膜炎/眼表面疾病组.
- 两轮匿名电子调查和讨论会议以根据诊断组件 (症状,检查,实验室,标准,治疗) 改进定义.
主要成果:
- 高达成共识率:在第一轮中,神经眼睛/轨道部件的共识率为86.3%,眼膜炎/眼表面部件的共识率为89.6%.
- 在经过修订后,为10/11神经眼睛/轨道疾病和9/10眼膜炎/眼表面疾病建立了共识定义.
- 定义的关键疾病包括视神经炎,轨道炎症,前/中间/后视膜炎,干眼病和硬化症.
结论:
- 开发的共识定义为Eye-irAEs提供了一个标准化的分类.
- 这些定义突出了irAEs和其他炎症性眼病之间的区别.
- 该指南预计将在临床实践和研究环境中得到广泛采用,以改善患者护理和科学进步.
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