Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, the Netherlands; and.
Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Retin Cases Brief Rep. 2022 Jul 1;16(4):430-434. doi: 10.1097/ICB.0000000000000999. Epub 2020 Apr 1.
To describe the pathological features, treatment, and resolution of pembrolizumab-associated retinal detachment.
A case report with a brief review of the literature and details of patient presentation, physical examination, systemic workup, fluorescein angiography, and indocyanine angiography.
A 25-year-old white woman was diagnosed with unresectable metastatic melanoma of the skin with a BRAF V600E mutation. The patient was treated with pembrolizumab injections every 3 weeks, upon which quick remission was seen of the metastases. After five injections, visual acuity of the patient deteriorated to 20/32 in the right eye. Ocular examination revealed bilateral panuveitis, papillitis, and serous retinal detachments. Treatment consisted of an oral prednisone taper schedule, topical prednisolone drops, and cessation of the pembrolizumab therapy, after which complete resolution of the subretinal fluid was seen.
Pembrolizumab therapy may cause the development of panuveitis, papillitis, and serous retinal detachment, symptoms which are able to be controlled with lengthy steroid therapy.
描述 pembrolizumab 相关性视网膜脱离的病理特征、治疗方法和转归。
通过病例报告并结合文献复习，详细介绍了患者的临床表现、体格检查、系统检查、荧光素血管造影和吲哚青绿血管造影。
一位 25 岁的白人女性被诊断为伴有 BRAF V600E 突变的不可切除皮肤转移性黑色素瘤。该患者接受 pembrolizumab 注射治疗，每 3 周一次，结果显示转移灶迅速消退。在接受五次注射后，该患者右眼视力下降至 20/32。眼部检查发现双侧全葡萄膜炎、视盘炎和浆液性视网膜脱离。治疗包括口服泼尼松龙减量方案、局部皮质类固醇滴注和停止 pembrolizumab 治疗，此后完全消退了视网膜下积液。
pembrolizumab 治疗可能导致全葡萄膜炎、视盘炎和浆液性视网膜脱离，这些症状可以通过长期类固醇治疗来控制。
