在视线之外,隐藏在简单的线索中
Laia Peraferrer-Montesinos1, Silvia Susin-Calle1, Jose E Martínez-Rodríguez1
1Neurology Department, Hospital del Mar Medical Research Institute, Barcelona, Spain.
Survey of ophthalmology
|November 7, 2025
概括
一名接受肺癌免疫治疗的患者由于免疫相关的不良事件而出现了突然的视力丧失,特别是髓寡干细胞糖蛋白抗体相关疾病,突出了神经瘤学的新挑战.
科学领域:
- 神经瘤学神经瘤学
- 免疫学 免疫学 免疫学
- 眼科医生 眼科 眼科
背景情况:
- 先进的非小细胞肺癌 (NSCLC) 治疗通常涉及化疗 (碳波拉丁,帕克利塔塞尔) 与免疫疗法 (pembrolizumab) 结合.
- 免疫疗法可以调节免疫系统,可能导致与免疫相关的不良事件 (irAEs).
研究的目的:
- 在接受NSCLC治疗的患者中报告一种罕见的双边严重视力损失病例.
- 为了说明潜在的与免疫相关的不良事件,模仿神经瘤疾病.
主要方法:
- 一个76岁的男性患者的病例报告,患有晚期NSCLC.
- 进行了临床表现,神经检查,眼科评估和大脑磁共振成像 (MRI).
- 诊断工作包括神经瘤差异诊断和针对特定抗体的测试.
主要成果:
- 患者出现了快速,严重的双边视力丧失和眼睛疼痛.
- 核磁共振扫描显示了视神经炎症 (FLAIR超强度和增强).
- 患者经历了部分自发的视觉恢复;怀疑诊断为髓寡干细胞糖蛋白抗体相关疾病 (MOGAD).
结论:
- 这一案例凸显了MOGAD在接受pembrolizumab治疗NSCLC的患者中作为潜在的irAE.
- 免疫疗法的进步需要对新型神经眼科IRAEs保持警.
- 在这种情况下,早期诊断和管理对于视力恢复至关重要.
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