免疫检查点抑制剂的神经眼科表现最新进展。

Update on Neuro-ophthalmic Manifestations of Immune Checkpoint Inhibitors.

机构信息

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.

出版信息

Curr Neurol Neurosci Rep. 2024 May;24(5):113-122. doi: 10.1007/s11910-024-01336-z. Epub 2024 Mar 18.

Abstract

PURPOSE OF REVIEW

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.

RECENT FINDINGS

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.

摘要

目的综述

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。

最近的发现

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。

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