Department of Ophthalmology, Royal Victoria Hospital , Belfast , Northern Ireland.
Department of Ophthalmology, Warrington & Holton Hospitals NHS Foundation Trust, Lovely Lane , Warrington , UK.
Ocul Immunol Inflamm. 2019;27(6):1012-1015. doi: 10.1080/09273948.2018.1459733. Epub 2018 Apr 19.
: To describe the presentation and management of severe ocular adverse events following treatment with pembrolizumab for cutaneous metastatic melanoma. : Interventional case report. : A 73-year-old Caucasian man receiving pembrolizumab treatment for metastatic melanoma presented with panuveitis and subsequent profound hypotony, choroidal effusions, and optic disk swelling bilaterally. Oral prednisolone controlled intraocular inflammation. However, bilateral hypotony persisted which was managed over a 12-month period with ocular viscoelastic device injections into the anterior chamber of both eyes. There was also phacoemulsification with pars plana vitrectomy (PPV) and silicone oil (SO) tamponade performed on the left eye only. Intraocular pressure (IOP) stabilized (>6 mmHg) with best-corrected visual acuity of 6/60. : We report a severe adverse event from pembrolizumab therapy resulting in uveitis and persistent hypotony. Repeat injections of high viscosity OVD achieved an increase in IOP up to 12 months. This technique may be a useful adjuvant or alternative to PPV and SO.
: 描述 pembrolizumab 治疗皮肤转移性黑色素瘤后发生严重眼部不良事件的表现和处理。 : 介入性病例报告。 : 一名 73 岁的高加索男性因转移性黑色素瘤接受 pembrolizumab 治疗，出现全葡萄膜炎，随后出现双侧严重低眼压、脉络膜积液和视盘肿胀。口服泼尼松龙控制眼内炎症。然而，双侧低眼压持续存在，通过在双眼前房注射眼用粘弹剂进行了 12 个月的管理。仅对左眼进行了晶状体超声乳化联合玻璃体切除术（PPV）和硅油（SO）填充。眼压（IOP）稳定（>6mmHg），最佳矫正视力为 6/60。 : 我们报告了 pembrolizumab 治疗导致葡萄膜炎和持续性低眼压的严重不良事件。重复注射高粘度 OVD 可将 IOP 提高至 12 个月。该技术可能是 PPV 和 SO 的有用辅助手段或替代方法。
