Ocular Complications of Checkpoint Inhibitors and Immunotherapeutic Agents: A Case Series

Ocul Immunol Inflamm. 2021 Nov 17;29(7-8):1585-1590. doi: 10.1080/09273948.2020.1766082. Epub 2020 Jul 9.

Abstract

Background: Ophthalmologists have a role in assessing immune-related adverse events (IRAE) in oncology patients on immunotherapy. We assessed the utility of a hospital-wide toxicity team in referring patients with new ocular symptoms for examination. We also identified new immunotherapy agents causing ocular side-effects.Design: A cohort study of eight consecutive patients on immunotherapy, who developed ocular IRAE from November 1, 2017 to June 30, 2019. All were seen at the Ocular Immunology Division of the Wilmer Eye Institute and referred by the Johns Hopkins Toxicity Team.Results: All eight patients on had IRAEs; were treated with corticosteroid drops or observation with clinical resolution. Two new agents, epocadostat and daratumumab, were associated with the development of uveitis.Conclusion: Ophthalmologists play an important role in a hospital-wide toxicity team and need to include IRAEs in their differential diagnosis. Given new drug development, ophthalmologists may be the first to identify IRAEs.

Keywords: Uveitis; drug toxicity; immunotherapy; multidisciplinary coordination of care; ocular adverse events.

MeSH terms

  • Aged
  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Drug-Related Side Effects and Adverse Reactions / physiopathology
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy / adverse effects
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Retinal Detachment / chemically induced*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / physiopathology
  • Retinal Hemorrhage / chemically induced*
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / physiopathology
  • Retrospective Studies
  • Uveitis / chemically induced*
  • Uveitis / diagnosis
  • Uveitis / physiopathology

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Immune Checkpoint Inhibitors
  • daratumumab