Multiple evanescent white dot syndrome-like reaction associated with ipilimumab and nivolumab immune checkpoint inhibitor therapy for metastasis of choroidal melanoma.
Autor: | Duong RT; University of Virginia School of Medicine, 200 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA., Ambati NR; University of Virginia School of Medicine, 200 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA., Peddada KV; University of Virginia Department of Ophthalmology 1300 Jefferson Park Ave. Charlottesville, VA, 22903, USA., Elghawy O; University of Virginia School of Medicine, 200 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA., Gaughan EM; University of Virginia Department of Hematology and Oncology, 200 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA., Shildkrot Y; University of Virginia Department of Ophthalmology 1300 Jefferson Park Ave. Charlottesville, VA, 22903, USA. |
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Jazyk: | angličtina |
Zdroj: | American journal of ophthalmology case reports [Am J Ophthalmol Case Rep] 2022 Jan 31; Vol. 25, pp. 101351. Date of Electronic Publication: 2022 Jan 31 (Print Publication: 2022). |
DOI: | 10.1016/j.ajoc.2022.101351 |
Abstrakt: | Purpose: To present a rare case of multiple evanescent white dot syndrome (MEWDS)-like presentation associated with immune checkpoint inhibitor therapy for metastatic choroidal melanoma. Observations: A 67-year-old non-myopic Caucasian female presented with bilateral worsening vision, flashes, and floaters after receiving two doses of ipilimumab and nivolumab for metastatic class 2 peripheral choroidal melanoma. Fundus imaging of the right eye revealed hypopigmented, extra-foveal scattered chorioretinal lesions with foveal granularity. Fluorescein angiogram and autofluorescence of the right eye demonstrated corresponding hyperfluorescent and hyperautofluorescent lesions in a wreath-like configuration. Optical coherence tomography of the right eye revealed subretinal fluid. Due to concurrent systemic side effects, checkpoint inhibitor therapy was paused and the patient was started on oral prednisone. At her one month follow up visit, her vision in her right eye returned to baseline and subretinal fluid resolved. Conclusions: This is the first reported case of a MEWDS-like chorioretinopathy after two cycles of ipilimumab/nivolumab therapy for metastatic choroidal melanoma. As immune checkpoint inhibitor therapy is still an evolving field, more research is needed to characterize ocular side effect profiles of these agents. Competing Interests: The following authors have no financial disclosures: RD, NA, KP, OE, EG, YS. (© 2022 The Authors.) |
Databáze: | MEDLINE |
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