Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab
Background. To present a rare case of a bilateral immune checkpoint inhibitor- (ICI-) induced photoreceptor injury with a bacillary layer detachment (BALAD) and a dissection of the photoreceptor inner and outer segment, accompanied by ICI-induced Vogt-Koyanagi-Harada- (VKH-) like uveitis after initi...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2023/9931794 |
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| author | Adnan Kilani Efstathios Vounotrypidis Susanna F. König Armin Wolf |
| author_facet | Adnan Kilani Efstathios Vounotrypidis Susanna F. König Armin Wolf |
| author_sort | Adnan Kilani |
| collection | DOAJ |
| description | Background. To present a rare case of a bilateral immune checkpoint inhibitor- (ICI-) induced photoreceptor injury with a bacillary layer detachment (BALAD) and a dissection of the photoreceptor inner and outer segment, accompanied by ICI-induced Vogt-Koyanagi-Harada- (VKH-) like uveitis after initial administration of nivolumab and ipilimumab. Case Presentation. A 52-year-old female with metastatic malignant cutaneous melanoma experiencing bilateral progressive visual acuity reduction, after treatment initiation with 1 mg/kg nivolumab and 3 mg/kg ipilimumab two weeks prior symptom onset. An extensive laboratory workup, including uveitis workup, onconeuronal and retinal antibodies, ruled out a paraneoplastic autoimmune disorder and a granulomatous disease. Furthermore, a B-scan was performed to exclude a posterior scleritis. Ensuing temporary treatment discontinuation of nivolumab and complete discontinuation of ipilimumab, treatment with high-dose systemic steroids was initiated, which resulted in alleviation of her symptoms and stability of ocular findings. Conclusions. ICIs can induce significant ocular side effects. As ocular inflammation can be well controlled using systemic steroids, treatment with ICIs can be continued whenever possible, in particular, if there is a good treatment response of the systemic malignancy. |
| format | Article |
| id | doaj-art-66983aa8ee4b411083a1714355395b93 |
| institution | Kabale University |
| issn | 2090-6730 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-66983aa8ee4b411083a1714355395b932025-02-03T06:47:33ZengWileyCase Reports in Ophthalmological Medicine2090-67302023-01-01202310.1155/2023/9931794Retinal Toxicity after Initial Administration of Nivolumab and IpilimumabAdnan Kilani0Efstathios Vounotrypidis1Susanna F. König2Armin Wolf3Department of OphthalmologyDepartment of OphthalmologyDepartment of OphthalmologyDepartment of OphthalmologyBackground. To present a rare case of a bilateral immune checkpoint inhibitor- (ICI-) induced photoreceptor injury with a bacillary layer detachment (BALAD) and a dissection of the photoreceptor inner and outer segment, accompanied by ICI-induced Vogt-Koyanagi-Harada- (VKH-) like uveitis after initial administration of nivolumab and ipilimumab. Case Presentation. A 52-year-old female with metastatic malignant cutaneous melanoma experiencing bilateral progressive visual acuity reduction, after treatment initiation with 1 mg/kg nivolumab and 3 mg/kg ipilimumab two weeks prior symptom onset. An extensive laboratory workup, including uveitis workup, onconeuronal and retinal antibodies, ruled out a paraneoplastic autoimmune disorder and a granulomatous disease. Furthermore, a B-scan was performed to exclude a posterior scleritis. Ensuing temporary treatment discontinuation of nivolumab and complete discontinuation of ipilimumab, treatment with high-dose systemic steroids was initiated, which resulted in alleviation of her symptoms and stability of ocular findings. Conclusions. ICIs can induce significant ocular side effects. As ocular inflammation can be well controlled using systemic steroids, treatment with ICIs can be continued whenever possible, in particular, if there is a good treatment response of the systemic malignancy.http://dx.doi.org/10.1155/2023/9931794 |
| spellingShingle | Adnan Kilani Efstathios Vounotrypidis Susanna F. König Armin Wolf Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab Case Reports in Ophthalmological Medicine |
| title | Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab |
| title_full | Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab |
| title_fullStr | Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab |
| title_full_unstemmed | Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab |
| title_short | Retinal Toxicity after Initial Administration of Nivolumab and Ipilimumab |
| title_sort | retinal toxicity after initial administration of nivolumab and ipilimumab |
| url | http://dx.doi.org/10.1155/2023/9931794 |
| work_keys_str_mv | AT adnankilani retinaltoxicityafterinitialadministrationofnivolumabandipilimumab AT efstathiosvounotrypidis retinaltoxicityafterinitialadministrationofnivolumabandipilimumab AT susannafkonig retinaltoxicityafterinitialadministrationofnivolumabandipilimumab AT arminwolf retinaltoxicityafterinitialadministrationofnivolumabandipilimumab |