Abstract
Purpose: To investigate the link between treatment with CTLA-4 and PD-1 checkpoint blockade inhibitors and the development of noninfectious uveitis. Methods: A survey was distributed to uveitis specialists to identify patients who developed uveitis while receiving either PD-1 inhibitors pembrolizumab and nivolumab; PD-L1 inhibitors atezolizumab, avelumab, and durvalumab; or the CTLA-4 inhibitor ipilimumab. Results: Fifteen patients from seven institutions were identified. The most common cancer diagnosis (13/15) was malignant melanoma. Fourteen patients had a new uveitis diagnosis following checkpoint blockade administration (six anterior uveitis, six panuveitis, one posterior uveitis, one anterior/intermediate combined); one patient developed optic neuritis. Uveitis was diagnosed within 6 months after drug initiation for 11/12 patients (median 63 days). Corticosteroid treatment was effective for most patients, although two patients had permanent loss of vision. Conclusions: Patients on checkpoint inhibitor therapy should be educated to seek care if they develop ocular symptoms, and prompt referral to specialists should be incorporated into oncology protocols.
Original language | English (US) |
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Pages (from-to) | 217-227 |
Number of pages | 11 |
Journal | Ocular Immunology and Inflammation |
Volume | 28 |
Issue number | 2 |
DOIs | |
State | Published - Feb 17 2020 |
Keywords
- CTLA-4
- Checkpoint inhibitor
- PD-1
- immunotherapy
- ocular inflammation
- uveitis
ASJC Scopus subject areas
- Immunology and Allergy
- Ophthalmology