Abstract:
PURPOSE:Immune checkpoint inhibitors (ICI) targeting the programmed cell death protein 1 (PD-1), or its ligand PD-L1, are the mainstay of metastatic cancer treatment. Patients receiving these treatments may develop immune-related adverse events (irAEs). This study aimed to estimate the prevalence and describe the clinical patterns of moderate-to-severe ocular irAEs-associated with anti-PD-(L)1 treatment. DESIGN:Prospective case series. METHODS:This study included patients recruited via (1) a single-center prospective cohort and (2) a national pharmacovigilance registry between June 2014 and March 2018, and focused on patients with moderate-to-severe ocular irAEs following anti-PD-(L)1. All patients underwent a comprehensive ophthalmologic assessment. The main outcome measure was the prevalence of moderate-to-severe ocular irAEs. RESULTS:Of a total of 745 patients included in the prospective cohort, 3 developed moderate-to-severe ocular irAEs, providing a prevalence of 0.4% and an incidence of 0.7 per 1000 patient-months of treatment. An additional 5 cases of moderate-to-severe ocular irAEs were reported through the national registry. From these 8 patients, 5 presented with intraocular inflammation, 2 with ocular surface disease, and 1 with orbital myopathy. Five patients (62.5%) experienced additional extraophthalmologic irAEs. Ocular irAEs led to permanent discontinuation of anti-PD-(L)1 in 4 patients. Treatment by local and/or systemic corticosteroids allowed resolution or control of the ocular symptoms in 7 of 8 patients. CONCLUSION:Although uncommon, anti-PD-(L)1-associated ocular complications may be sight-threatening and lead to discontinuation of anti-PD-(L)1 treatments. Patients complaining of eye problems while receiving ICI treatment should immediately be seen by an ophthalmologist.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Bitton K,Michot JM,Barreau E,Lambotte O,Haigh O,Marabelle A,Voisin AL,Mateus C,Rémond AL,Couret C,Champiat S,Labetoulle M,Rousseau Adoi
10.1016/j.ajo.2019.02.012subject
Has Abstractpub_date
2019-06-01 00:00:00pages
109-117eissn
0002-9394issn
1879-1891pii
S0002-9394(19)30064-9journal_volume
202pub_type
杂志文章abstract::We examined a patient who had syphilitic perioptic neuritis, a rarely diagnosed inflammation of the sheaths of the optic nerves that may be confused with papilledema caused by brain tumor or pseudotumor cerebri. The visual acuity was typically normal, and the only visual-field abnormality was enlargement of the blind ...
journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-03-01 00:00:00