UNASSIGNED: A 37-year-old woman with recurrent metastatic ovarian cancer presented with blurred vision and photophobia after receiving pembrolizumab. Ocular findings were bilateral anterior chamber reactions, iris cysts, and macular flecks. Optical coherence tomography (OCT) indicated retinal pigment epithelium (RPE) and ellipsoid-band disruption. Her symptoms subsided with topical steroids but fundal appearance persisted despite cessation of immunotherapies. Similar episodes attacked again with multiple exudative subretinal fluid (SRF) developed after she received pembrolizumab and nivolumab. Steroids could cease anterior chamber reactions while SRF only subsided after discontinuation of immunotherapy. Extensive RPE and ellipsoid-band disruption remained without vision improvements.
UNASSIGNED: We report a rare case of uveitis and retinopathy after immunotherapies with sequent pembrolizumab and nivolumab. A serial change of the maculopathy is demonstrated. Possible ocular toxicities during the treatment course should be considered, and the benefits of continuing the immunotherapy must be weighed against the risks.
■一名37岁女性复发性转移性卵巢癌患者在接受派姆单抗治疗后出现视力模糊和畏光。眼部表现为双侧前房反应,虹膜囊肿,和黄斑斑点。光学相干断层扫描(OCT)显示视网膜色素上皮(RPE)和椭球带破裂。她的症状因局部类固醇而消退,但尽管停止了免疫疗法,眼底外观仍然存在。在接受pembrolizumab和nivolumab后,多次渗出性视网膜下液(SRF)再次发作。类固醇可以停止前房反应,而SRF仅在停止免疫疗法后消退。广泛的RPE和椭球带破坏仍然没有视力改善。
■我们报告了一例罕见的葡萄膜炎和视网膜病变的病例,随后使用派姆单抗和纳武单抗进行免疫治疗。显示了黄斑病变的一系列变化。应考虑治疗过程中可能的眼部毒性,必须权衡继续免疫治疗的益处和风险。