Table 1 Cases of Melanoma Associated Retinopathy (MAR)
Article | ICI | Age (y), gender | Previous therapy | Cancer | Symptoms | Initial BCVA | Time to onset | Antiretinal antibodies | Antitumor efficacy of ICI | Other IRAE | Treatment | Ophthalmological outcome | ICI discontinued | Recurrence after rechallenge | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Khaddour et al. (2021) [7] | Pembrolizumab | 74, M | Surgery | Metastatic cutaneous melanoma | Nyctalopia and shimmering lights | NS | MAR before introduction of pembrolizumab | / | CR | Vitiligo | / | Significant improvement in visual symptoms, ERG normalization | After 17 cycles | No rechallenge | 3.5 years |
Poujade et al. (2021) [8] | Pembrolizumab | 68, F | Surgery, a | Metastatic conjunctival melanoma | Blurred vision, photosensitivity, floaters | NS | MAR before introduction of pembrolizumab | TRPM1 | Regression of the gallbladder metastasis; increased vitiligo | NS | IVI DXM | Fewer floaters, but still undetectable dark-adapted ERG | N | No discontinuation | NS |
Shahzad et al. (2021) [9] | Ipilimumab + nivolumab | 56, M | Exenteration OS | Metastatic uveal melanoma | Flashing lights, visual aura | OD 6/18 | 3 weeks | NS | Partial response | Pneumonitis | Oral and intraocular CSb IVI ranibizumab | Permanent loss of vision; macular scarring | Y | No rechallenge | Alive 22 months |
Kim et al. (2020) [10] | Nivolumab | 58, M | Surgery, radiotherapy | Metastatic cutaneous melanoma | Asymmetric vision loss | OD 20/32 OS 20/2000 | 4 cycles | TRPM1, aldolase C | NS | NS | IVI Bevacizumab OS x2 oral CSc | OD 20/50 OS hand motion SRF disappeared, PED remained | N | No discontinuation | 4 months |
Dolaghan et al. (2019) [11] | Ipilimumab/Nivolumab and pembrolizumab | 72, M | NS | Metastatic melanoma | Bilateral uveitis | OS 6/24 | 2 cycles of I/N, 5 cycles of P | Recoverin, CA II | Complete radiological response | Grade 2 colitis, adrenal insufficiency and diabetes | Maxidex | Resolution of ocular inflammation, OS 6/24 | Y | NS | NS |
Elwood et al. (2021) [12] | Ipilimumab + nivolumab | 65, F | Surgery | Metastatic malignant melanoma | Photopsia, visual field loss | OD 20/40 OS 20/50 | 4 cycles | 60 kDa | Tumor regression without recurrence | Diarrhea, vomiting, and adrenal insufficiency | Bevacizumab OD, subtenon TA OS | OD 20/25 resolution of SRF and subretinal hyperreflectivity OS 20/100 Photopsia and VF improved | Y | No rechallenge | 10 months |
Kim et al. (2019) [13] | Nivolumab + ipilimumab | 79, F | NS | Metastatic cutaneous melanoma | Floaters, photopsia, nyctalopia | OD 20/20 OS 20/25 | 1 cycle | Y, not in detail mentioned | CR | Transaminitis, rash, hypophysitis | IV CS, IVIG | 20/20 OU, no improvement in DA | Y | No rechallenge | 10 months |
Roberts et al. (2016) [14] | Pembrolizumab | NS | Surgery, radiotherapy | Metastatic cutaneous melanoma | Nyctalopia, smoke-like vision | OD 20/20 OS 20/25 | Shortly after initiation | 23-kDa*, 30-kDa (CA II), 34-kDa, 40-kDa (aldolase), 42-kDa, 46-kDa (enolase), and 136-kDa | Partial response | NS | / | BCVA stable, gradual loss of pigmentation | N | No discontinuation | 15 weeks |
Audemard et al. (2013) [15] | Ipilimumab | 70, F | Surgery, chemotherapy | Metastatic cutaneous melanoma | Progressive vision loss | NS | MAR before introduction of ipilimumab | NS | Stable disease | Vitiligo | CS before ipilimumab | BCVA decreased | N | No discontinuation | 4 cycles |