Autoimmune retinopathy with associated anti-retinal antibodies as a potential immune-related adverse event associated with immunotherapy in patients with advanced cutaneous melanoma: case series and systematic review.

Autor:	Heng JS; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA., Kim JM; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA., Jones DK; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA., Stoessel KM; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA., Weiss SA; Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA., Sznol M; Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA., Kluger HM; Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA., Walter SD; Retina Consultants, P.C, Hartford, Connecticut, USA.; Hartford HealthCare Cancer Institute, Hartford Hospital, Hartford, Connecticut, USA., Silverstein NA; Silverstein Eye Center, Chester, New Jersey, USA., Pointdujour-Lim R; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA.; Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA.
Jazyk:	angličtina
Zdroj:	BMJ open ophthalmology [BMJ Open Ophthalmol] 2022 Jan 03; Vol. 7 (1), pp. e000889. Date of Electronic Publication: 2022 Jan 03 (Print Publication: 2022).
DOI:	10.1136/bmjophth-2021-000889
Abstrakt:	Objective: To demonstrate the spectrum of autoimmune retinopathy (AIR) associated with immunotherapy for advanced cutaneous melanoma. Methods and Analysis: Retrospective chart review on patients with advanced cutaneous melanoma who developed AIR after initiating immunotherapy. Complete ophthalmic examination and relevant ancillary testing were performed on each patient. The presence of AIR-associated anti-retinal antibodies was confirmed by western blot and/or immunohistochemical staining. Ophthalmic and systemic outcomes after treatment for AIR were followed over time. A systematic review of AIR associated with immunotherapy for cutaneous or non-ocular mucosal melanoma was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Case 1 developed photopsia and nyctalopia with electroretinographic findings characteristic for melanoma-associated retinopathy 1 week after initiating ipilimumab/nivolumab immunotherapy. Case 2 experienced new severe bilateral visual field loss associated with anti-retinal and anti-optic nerve antibodies while on maintenance nivolumab immunotherapy. Case 3 developed decreased visual acuity due to acute exudative polymorphous vitelliform maculopathy within 2 weeks of initiating ipilimumab/nivolumab immunotherapy. All patients had concurrent extraocular immune-related adverse events in addition to the presence of anti-retinal antibodies on serological testing. 14 published cases of AIR associated with immunotherapy for cutaneous or non-ocular mucosal melanoma were identified and reviewed. Conclusions: Immune checkpoint inhibition can trigger the development of AIR with varied clinical manifestations in patients with advanced cutaneous melanoma. This study highlights the need for close monitoring in cutaneous melanoma patients receiving immunotherapy who develop new visual symptoms with or without funduscopic changes, as well as the potential role for screening of patients prior to initiating immunotherapy. Competing Interests: Competing interests: HMK reports research grants from Merck, Bristol-Myers Squibb and Apexigen. She receives personal fees from Regeneron, Alexion, Prometheus, Corvus, Nektar, Biodesix, Roche-Genentech, Pfizer, Iovance, Immunocore and Celldex. MS is a paid consultant for Genentech-Roche, Bristol-Myers, Astra-Zeneca/Medimmune, Novartis, Seattle Genetics, Nektar, Lilly, Biodesix, Modulate Therapeutics. Newlink Genetics, Molecular Partners, Innate Pharma, Abbvie, Immunocore, Genmab, Almac, Hinge, Allakos, Anaeropharma, Array. He is also on the scientific advisory board for Symphogen, Adaptimmune, Omniox, Pieris, Torque (also receives consulting fees+stock options) and Verseau. SDW is a consultant for Allergan, Genentech and Castle Biosciences. SAW is a consultant for Array Biopharma and Magellan Rx. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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