Relation between ocular paraneoplastic syndromes and Immune Checkpoint Inhibitors (ICI): review of literature

Casselman, Pauline; Jacob, Julie; Schauwvlieghe, Pieter-Paul

doi:10.1186/s12348-023-00338-1

Journal of Ophthalmic Inflammation and Infection

Table 2 Cases of Carcinoma Associated Retinopathy (CAR)

From: Relation between ocular paraneoplastic syndromes and Immune Checkpoint Inhibitors (ICI): review of literature

Article	ICI	Age (y), gender	Previous/concurrent therapy	Cancer	Symptoms	Initial BCVA	Time to onset	Antiretinal antibodies	Antitumor efficacy of ICI	Other IRAE	Treatment	ICI discontinued	Ophthalmological outcome	Recurrence after rechallenge	Follow-up
Chauhan et al. (2022) [16]	Atezolizumab	75, M	C: chemotherapy	SCLC	Acute vision loss, floaters and photopsia	NLP	3 weeks	TULP1	NS	NS	Oral and local CS^a; rituximab	Y	OD 20/40 OS 20/30 Fundus, OCT stable	N, rechallenge concomitant with CS and rituximab	27 weeks
Chen et al. (2022) [17]	Nivolumab	57, M	P: Chemotherapy	HCC	VF constriction OU	20/25 OU	16 days	Recoverin	NS	NS	Systemic CS^b	Y	20/20 OU Slight VF improvement OCT, ERG almost stable	No rechallenge	24 months
Ghoraba et al. (2022) [18]	Pembrolizumab	52, F	P: surgery, radiotherapy, chemotherapy C: lenvatinib	Metastatic endometrial carcinoma	Nyctalopia, photosensitivity and photopsia	20/20 OU	18 months	CA II, enolase and arrestin	NS	Arrhythmia, electrolyte imbalance, hypothyroidism and severe diarrhea	/	Y	Full recovery of visual symptoms, normalization of full-field ERG	No rechallenge	7 months
Young et al. (2021) [19]	Nivolumab + Ipilimumab	NS	NS	Cervical cancer	NS	NS	NS	NS	NS	/	IV MP, plasmapheresis	NS	NS	NS	NS
Reddy et al. (2017) [20]	Nivolumab	64, F	P: chemotherapy, radiotherapy	Lung adenocarcinoma	Photopsias OD> OS, OD dark paracentral halo and color vision problems	OD 20/32 OS 20/20	Shortly afterwards	30-kDa (CA II), 35-kDa (GAPDH), 38-kDA, 58-kDa (PKM2), and 112-kDa	NS	Pericardial effusion, memory loss	PO CS^c	Y	Resolution of symptoms, stability of ocular findings	No rechallenge	3 months

ICI Immune checkpoint inhibitor, Y Years, BCVA Best corrected visual acuity, IRAE Immune-related adverse events, M Man, C Concurrent, SCLC Small-cell lung cancer, NLP No light perception, TULP1 Tubby-related protein 1, NS Not specified, CS Corticosteroids, Y Yes, OD Right eye, OS Left eye, OCT Optical coherence tomography, N No, P Previous, HCC Hepatocellular carcinoma, VF Visual field, OU Both eyes, ERG Electroretinography, F Female, CA II Carbonic anhydrase II, IV Intravenous, MP Methylprednisolone, GAPDH Glyceraldehyde-3-Phosphate Dehydrogenase, PKM2 Pyruvate kinase M2, PO By mouth
^a80 mg prednisone, tapered; 4 mg intravitreal preservative-free triamcinolone acetonide (Triesence, Alcon, Fort Worth, Texas, USA)
^bIntravenous methylprednisolone (250 mg/day) for 3 days
^cOral prednisone 60 mg once daily; after 3 weeks slow taper of the prednisone, reducing by 10 mg every 3 weeks

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