免疫检查点抑制剂相关的双边视神经炎
Chris Gyan1, Maria Bonello2, Ashwin Arnold Pinto3
1Department of Neurology, Southampton General Hospital, Southampton, UK chris_gyan@hotmail.com.
Practical neurology
|July 31, 2025
概括
视神经炎是免疫检查点抑制剂的罕见副作用,如nivolumab. 早期识别和用皮质类固醇或血交换治疗可以改善视力结果.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 神经眼科神经眼科
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 免疫相关不良事件 (irAEs) 是ICI治疗的潜在并发症.
- 视神经炎是一种罕见但严重的与ICI相关的irAE,可能导致视力丧失.
研究的目的:
- 在接受nivolumab治疗的患者中报告视神经炎病例.
- 突出早期识别和治疗ICI诱导的视神经炎的重要性.
主要方法:
- 一位患有转移性恶性黑色素瘤的老年妇女的病例报告.
- 用尼沃卢马布 (一种编程细胞死亡蛋白1抑制剂) 治疗.
- 监测不良事件,包括视觉变化.
主要成果:
- 患者在尼沃卢马布治疗2个月后出现双边无痛视力丧失.
- 视神经炎的诊断证实为irAE.
- 患者接受了基于类似情况的专家意见的治疗.
结论:
- 视神经炎是一种新兴的irAE,随着ICI的扩大使用.
- 及时诊断和干预,可能是用皮质类固醇或血交换,对于保持视力至关重要.
- 在接受ICI的患者中,需要提高对视神经炎的警.
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