Ankur Sudhir Gupta¹, Nicholas Dolan² and James Kasenchak¹*

¹Geisinger Eye Institute, Danville, PA, USA
²Marshall University Medical School, Huntington, WV, USA

*Corresponding Author: James Kasenchak, Geisinger Eye Institute, Danville, PA, USA.

Received: April 20, 2022; Published: May 18, 2022

Abstract

We present a case of severe hypotony complicated by cystoid macular edema, optic neuritis and panuveitis secondary to immune check point inhibitors. This is a unique case due to the severity of the complications from the check point inhibitors and the fact that it was refractory to treatment. It will serve as a guide for oncologist and ophthalmologists to recognize the importance of early diagnosis and treatment of the ocular complications of these increasingly commonly prescribed medications.

Keywords: Checkpoint Inhibitor; Hypotony; Panuveitis; Cancer; Choroidal Folds

References

1. Kooshkaki O., et al. “Combination of Ipilimumab and Nivolumab in Cancers: From Clinical Practice to Ongoing Clinical Trials”. International Journal of Molecular Sciences 12 (2020): 4427.
2. Buchbinder EI and Desai A. “CTLA-4 and PD-1 Pathways: Similarities, Differences, and Implications of Their Inhibition”. American Journal of Clinical Oncology 1 (2016): 98-106.
3. Zhou L and Wei X. “Ocular Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Lung Cancer”. Frontiers in Immunology 12 (2021):
4. Papavasileiou E., et al. “Ipilimumab-induced Ocular and Orbital Inflammation--A Case Series and Review of the Literature”. Ocular Immunology and Inflammation 2 (2016): 140-146.
5. Nallapaneni NN., et al. “Ipilimumab-induced hypophysitis and uveitis in a patient with metastatic melanoma and a history of ipilimumab-induced skin rash”. Journal of the National Comprehensive Cancer Network 8 (2014): 1077-1081.
6. Baughman DM., et al. “Bilateral Uveitis and Keratitis Following Nivolumab Treatment for Metastatic Melanoma”. Medical Case Reports (Wilmington)2 (2017): 8.
7. Obata S., et al. “Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma”. Case Report on Ophthalmology1 (2019): 67-74.
8. Attia P., et al. “Autoimmunity correlates with tumor regression in patients with metastatic melanoma treated with anti-cytotoxic T-lymphocyte antigen-4”. Journal of Clinical Oncology25 (2005): 6043-6053.
9. Tsui E and Gonzales JA. “Retinal Vasculitis Associated with Ipilimumab”. Ocular Immunology and Inflammation 6 (2020): 868-870.
10. Thomas M., et al. “Hypotony Maculopathy: Clinical Presentation and Therapeutic Methods”. Ophthalmology Therapy2 (2015): 79-88.
11. Tran VT., et al. “Appraisal and management of ocular hypotony and glaucoma associated with uveitis”. International Ophthalmology Clinics 2 (2000): 175-203.
12. Agrawal RV., et al. “Current approach in diagnosis and management of anterior uveitis. Indian Journal of Ophthalmology1 (2010): 11-19.

Citation

Citation: Kasenchak., et al. “Refractive Ocular Hypotony Associated with Immune Check Point Inhibitors".Acta Scientific Ophthalmology 5.6 (2022): 68-71.

Copyright

Copyright: © 2022 Kasenchak., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.