Mukharesh Loulwah, Chwalisz Bart K
Department of Ophthalmology, Massachusetts Eye & Ear/Harvard Medical School, Boston, MA, USA.
Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Semin Ophthalmol. 2021 May 19;36(4):241-249. doi: 10.1080/08820538.2021.1890796. Epub 2021 Feb 27.
Immune checkpoint inhibitors (ICIs) have revolutionized the field of oncology by modulating the immune cell-cancer cell interaction and thereby promoting immune system disinhibition in order to target several types of malignancies. There are three classes of immune checkpoint inhibitors (ICIs): anti-cytotoxic T-lymphocyte associated antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1), and anti-programmed cell death ligand-1 (PD-L1).It is not uncommon for physicians across all specialties to encounter a patient with a history of malignancy and ICI exposure, necessitating familiarity with their potential complications. In this review article, we discuss the most common immune-related adverse events (irAEs) pertaining to the central and peripheral nervous systems and their potential afferent and efferent neuro-ophthalmic manifestations. Early recognition and treatment of these irAEs, and discontinuation of the offending ICI are all critical steps to prevent morbidity and mortality.
免疫检查点抑制剂（ICIs）通过调节免疫细胞与癌细胞的相互作用，从而促进免疫系统去抑制，以靶向多种类型的恶性肿瘤，彻底改变了肿瘤学领域。免疫检查点抑制剂（ICIs）有三类：抗细胞毒性T淋巴细胞相关抗原4（CTLA-4）、抗程序性细胞死亡蛋白1（PD-1）和抗程序性细胞死亡配体1（PD-L1）。所有专科的医生遇到有恶性肿瘤病史且接触过ICI的患者并不罕见，因此有必要熟悉其潜在并发症。在这篇综述文章中，我们讨论了与中枢和外周神经系统相关的最常见免疫相关不良事件（irAEs）及其潜在的传入和传出神经眼科表现。对这些irAEs的早期识别和治疗，以及停用有问题的ICI都是预防发病和死亡的关键步骤。
