免疫检查点抑制剂诱导的炎症和视神经疾病后的药物挑战
Julia Canestraro1,2, Rebecca F Silverman3, David H Abramson1,2
1Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ocular oncology and pathology
|February 13, 2026
概括
免疫检查点抑制器视神经疾病 (ICI-OND) 通常会导致无痛的视力丧失. 用类固醇治疗和ICI停止改善视力,并重新挑战ICI通常是安全的.
科学领域:
- 眼科医生 眼科 眼科
- 神经瘤学神经瘤学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是关键的癌症疗法.
- 视神经疾病 (OND) 是ICI的潜在副作用.
- 了解ICI-OND的临床特征和结果至关重要.
研究的目的:
- 描述ICI-OND的临床特征,包括视神经炎,椎间盘,周神经炎和皮膜炎.
- 评估ICI-OND的管理策略和长期成果.
- 在ICI-OND之后评估ICI重新挑战的安全性和有效性.
主要方法:
- 20名连续ICI-OND患者的回顾性分析.
- 包括37只眼睛在一个三级癌症中心接受治疗.
- 收集关于临床表现,诊断测试,治疗和结果的数据.
主要成果:
- 大多数ICI-OND病例呈现无痛视力丧失 (85%),双边参与 (70%) 和异色素 (59%).
- 异常视野 (79%),OCT (80%) 和MRI (56%) 是常见的.
- 在类固醇治疗和ICI停止后,84%的眼睛的视力得到改善;在5名重新接受ICI的患者中,有4人耐受了ICI,没有复发.
结论:
- ICI-OND通常表现为双边,无痛的视力下降与彩色视力缺陷.
- 系统性类固醇和ICI停止可以恢复视力至20/40或更好.
- 在完成类固醇治疗后,ICI-OND复发似乎在大多数患者中是安全的,ICI-OND没有复发.
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