PDF(Pubmed)
Abstract：
UNASSIGNED: Immunotherapy has become an important addition to oncology treatment plans in recent years. As these therapies become more widely employed, many unique side effects have been reported. In ophthalmology the most well-documented side effects of immune checkpoint inhibitors (ICI) include uveitis, macular edema and dry eye syndrome. This manuscript describes a rare case of bilateral choroidal effusions and secondary angle narrowing in the setting of systemic capillary leak syndrome (SCLS) from an HLA-directed vaccine and an ICI, pembrolizumab, for the treatment of stage IV squamous cell carcinoma (SCC) of the lung.
UNASSIGNED: A 67-year-old male with a history of stage IV SCC of the lung status-post pneumonectomy presented to the emergency department due to functional decline, anasarca, and dyspnea after receiving an HLA-directed vaccine in combination with pembrolizumab. Extensive workup revealed that his symptoms were secondary to SCLS. Ophthalmology was consulted due bilateral choroidal detachments seen on magnetic resonance imaging. B-scan ultrasound and ultrasound biomicroscopy revealed large, non-appositional choroidal effusions with anterior rotation of the ciliary body. Given minimal response to oral steroid therapy, sub-Tenon\'s triamcinolone acetonide, atropine, and intraocular pressure-lowering eyedrops were initiated with a good response.
UNASSIGNED: Choroidal effusions and secondary angle closure can be rare complications of SCLS in the setting of ICIs. Clinicians must be aware of the potentials side effects of ICI therapy, as these medications become more commonly used.
UNASSIGNED: A 67-year-old male with a history of stage IV SCC of the lung status-post pneumonectomy presented to the emergency department due to functional decline, anasarca, and dyspnea after receiving an HLA-directed vaccine in combination with pembrolizumab. Extensive workup revealed that his symptoms were secondary to SCLS. Ophthalmology was consulted due bilateral choroidal detachments seen on magnetic resonance imaging. B-scan ultrasound and ultrasound biomicroscopy revealed large, non-appositional choroidal effusions with anterior rotation of the ciliary body. Given minimal response to oral steroid therapy, sub-Tenon\'s triamcinolone acetonide, atropine, and intraocular pressure-lowering eyedrops were initiated with a good response.
UNASSIGNED: Choroidal effusions and secondary angle closure can be rare complications of SCLS in the setting of ICIs. Clinicians must be aware of the potentials side effects of ICI therapy, as these medications become more commonly used.
摘要：
UNASSIGNED：近年来，免疫治疗已成为肿瘤治疗计划的重要补充。随着这些疗法的应用越来越广泛，已经报道了许多独特的副作用。在眼科中，最有据可查的免疫检查点抑制剂（ICI）的副作用包括葡萄膜炎，黄斑水肿和干眼症。该手稿描述了在HLA定向疫苗和ICIpembrolizumab的全身性毛细血管渗漏综合征（SCLS）的背景下，双侧脉络膜积液和继发性角度狭窄的罕见病例。用于治疗IV期肺鳞状细胞癌（SCC）。
UNASSIGNED：一名67岁男性，因功能下降，在肺切除术后，有肺部状态的IV期SCC病史，Anasarca,在接受HLA定向疫苗与pembrolizumab组合后呼吸困难。广泛的检查显示他的症状是SCLS继发的。由于在磁共振成像上看到双侧脉络膜脱离，因此咨询了眼科。B超和超声生物显微镜显示大，睫状体前旋的非并置脉络膜积液。鉴于对口服类固醇治疗的反应很小，Sub-Tenon\'s曲安奈德，阿托品,和降低眼压的滴眼液开始有良好的反应。
UNASSIGNED：脉络膜积液和继发性闭角可能是ICIs设置中SCLS的罕见并发症。临床医生必须意识到ICI治疗的潜在副作用，随着这些药物的使用越来越普遍。
UNASSIGNED：一名67岁男性，因功能下降，在肺切除术后，有肺部状态的IV期SCC病史，Anasarca,在接受HLA定向疫苗与pembrolizumab组合后呼吸困难。广泛的检查显示他的症状是SCLS继发的。由于在磁共振成像上看到双侧脉络膜脱离，因此咨询了眼科。B超和超声生物显微镜显示大，睫状体前旋的非并置脉络膜积液。鉴于对口服类固醇治疗的反应很小，Sub-Tenon\'s曲安奈德，阿托品,和降低眼压的滴眼液开始有良好的反应。
UNASSIGNED：脉络膜积液和继发性闭角可能是ICIs设置中SCLS的罕见并发症。临床医生必须意识到ICI治疗的潜在副作用，随着这些药物的使用越来越普遍。
