Neuro-Ophthalmology Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Curr Neurol Neurosci Rep. 2024 May;24(5):113-122. doi: 10.1007/s11910-024-01336-z. Epub 2024 Mar 18.
Immune checkpoint inhibitor (ICI) use has been on the rise for treatment of many different malignancies. Subsequently, more has been learned about immune-related adverse events (irAEs) that occur up to 12 months after treatment. This review summarizes the latest findings and management of neuro-ophthalmic associated irAEs.
irAEs can affect the afferent and efferent neuro-ophthalmic pathways, thereby targeting central and peripheral nervous systems. As more cases are being reported, it is becoming apparent that neuro-ophthalmic irAEs often present with atypical features when compared to their spontaneous autoimmune counterparts. These neuro-ophthalmic presentations can also be signs of a more extensive inflammatory process that spans other organ systems, such as myopathies, endocrinopathies, and paraneoplastic syndromes. Awareness of neuro-ophthalmic irAEs and their atypical presentations can lead to early detection, termination of ICI treatment, and immunosuppressant therapy initiation.
免疫检查点抑制剂（ICI）的应用在治疗多种不同恶性肿瘤方面呈上升趋势。因此，人们对治疗后长达 12 个月发生的免疫相关不良事件（irAEs）有了更多的了解。本综述总结了与神经眼科相关的 irAEs 的最新发现和管理。
irAEs 可影响传入和传出神经眼科途径，从而靶向中枢和周围神经系统。随着越来越多的病例被报道，与自发自身免疫性疾病相比，神经眼科 irAEs 通常表现出不典型的特征这一现象变得越来越明显。这些神经眼科表现也可能是更广泛的炎症过程的迹象，该过程跨越其他器官系统，如肌病、内分泌疾病和副肿瘤综合征。对神经眼科 irAEs 及其不典型表现的认识可导致早期发现、ICI 治疗的终止和免疫抑制剂治疗的启动。
