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Background/Purpose: To describe a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) that was mistaken for nivolumab-induced Vogt-Koyanagi-Harada disease-like syndrome. Methods: We present the case of a 58-year-old white man with metastatic renal clear cell carcinoma for which he was palliatively treated with IV nivolumab immunotherapy. The patient developed subacute onset of blurry vision and gray spots in the visual fields of both eyes, macular subretinal fluid, thickening of the retinal pigment epithelium, and swollen optic nerve heads. Differential diagnosis included nivolumab-induced Vogt-Koyanagi-Harada disease-like syndrome, and the patient was initially treated with steroids, which gave no improvement. Investigation showed the development of dark-gray patches in the peripheral retina of both eyes and cataract, which prompted reevaluation of the diagnosis, deeming BDUMP most likely. The patient was successfully treated with plasmapheresis. Results: The initial presentation of the case was incorrectly diagnosed as nivolumabinduced Vogt-Koyanagi-Harada disease-like syndrome. On repeat studies of the patients' symptoms and imaging, we concluded we had missed signs of BDUMP. Conclusion: The diagnosis BDUMP was missed in the first evaluation. We present this case to discuss the similarities and differences between this disease and nivolumabinduced Vogt-Koyanagi-Harada disease-like syndrome. More importantly, we want to highlight that reevaluation of the diagnosis on worsening of a disease was key in this unusual case. [ABSTRACT FROM AUTHOR]

A case report regarding a patient with metastatic melanoma who exhibited bilateral serous retinal detachment and uveitis after administration of pembrolizumab. The symptoms resolved after cessation of the pembrolizumab treatment cycles and initiation of oral and topical prednisone. Purpose: To describe the pathological features, treatment, and resolution of pembrolizumab-associated retinal detachment. Methods: A case report with a brief review of the literature and details of patient presentation, physical examination, systemic workup, fluorescein angiography, and indocyanine angiography. Results: 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. Conclusion: Pembrolizumab therapy may cause the development of panuveitis, papillitis, and serous retinal detachment, symptoms which are able to be controlled with lengthy steroid therapy. [ABSTRACT FROM AUTHOR]

Purpose: The vitreous proteome might provide an attractive gateway to discriminate between various uveitis aetiologies and gain novel insights into the underlying pathophysiological processes. Here, we investigated 180 vitreous proteins to discover novel biomarkers and broaden disease insights by comparing (1). primary vitreoretinal lymphoma ((P)VRL) versus other aetiologies, (2). sarcoid uveitis versus tuberculosis (TB)‐associated uveitis and (3). granulomatous (sarcoid and TB) uveitis versus other aetiologies. Methods: Vitreous protein levels were determined by proximity extension assay in 47 patients with intraocular inflammation and a prestudy diagnosis (cohort 1; training) and 22 patients with a blinded diagnosis (cohort 2; validation). Differentially expressed proteins identified by t‐tests on cohort 1 were used to calculate Youden's indices. Pathway and network analysis was performed by ingenuity pathway analysis. A random forest classifier was trained to predict the diagnosis of blinded patients. Results: For (P)VRL stratification, the previously reported combined diagnostic value of IL‐10 and IL‐6 was confirmed. Additionally, CD70 was identified as potential novel marker for (P)VRL. However, the classifier trained on the entire cohort (cohort 1 and 2) relied primarily on the interleukin score for intraocular lymphoma diagnosis (ISOLD) or IL‐10/IL‐6 ratio and only showed a supportive role for CD70. Furthermore, sarcoid uveitis displayed increased levels of vitreous CCL17 as compared to TB‐associated uveitis. Conclusion: We underline the previously reported value of the ISOLD and the IL‐10/IL‐6 ratio for (P)VRL identification and present CD70 as a potentially valuable target for (P)VRL stratification. Finally, we also show that increased CCL17 levels might help to distinguish sarcoid uveitis from TB‐associated uveitis. [ABSTRACT FROM AUTHOR]

A case report describing a patient with a rhegmatogenous retinal detachment who underwent reattachment surgery via a perfluorocarbon liquid-assisted pars plana vitrectomy. Optical coherence tomography in follow-up visits showed a small subretinal perfluorocarbon liquid bubble that migrated through the retina and resolved spontaneously in the following months. Purpose: To demonstrate unique behavior of subretinal perfluorocarbon liquid (PFCL) following macular reattachment surgery. Methods: An observational case report. Changes in visual functioning and consecutive optical coherence tomograms are described. Results: Following macular reattachment surgery with the aid of PFCL, a small residual PFCL bubble, measuring 175 μ m in diameter, is noted beneath the fovea on optical coherence tomogram. During nine months of follow-up, the bubble is shown to elongate and migrate toward the vitreous space. Once the bubble reaches the inner retinal surface, it gradually becomes smaller and disappears completely. We observed anatomical restoration of the retinal layers, and maintenance of fair visual acuity (20/32 feet) without scotoma. Conclusion: This report shows the potential of PFCL to migrate through the retina toward the vitreous. Rather than opt for a second surgery to remove small PFCL bubbles, observation may be clinically appropriate in selected cases. [ABSTRACT FROM AUTHOR]

Background: Retinal detachment is more common among uveitis patients than in the general population. Here, we aimed to assess the prevalence of rhegmatogenous retinal detachment (RRD) in a uveitis population. Methods: We retrospectively studied 851 uveitis patients, recording characteristics such as uveitis duration, anatomical location, and cause; RRD occurrence; proliferative vitreoretinopathy (PVR) at presentation; surgical approach; reattachment rate; and initial and final visual acuity (VA). Results: RRD occurred in 26 patients (3.1%; 29 affected eyes) and was significantly associated with posterior uveitis ( p < 0.001), infectious uveitis ( p < 0.001), and male gender ( p = 0.012). Among cases of infectious uveitis, cytomegalovirus and varicella zoster virus were most commonly associated with RRD development. RRD in non-infectious uveitis was not found to be associated with any specific uveitis entity. The rate of single-operation reattachment was 48%, and the rate of final reattachment was 83%. Mean final VA was 20/125, with 41% of eyes ultimately having a VA of less than 20/200. Conclusion: Uveitis is a risk factor for RRD development, which carries a poor prognosis. [ABSTRACT FROM AUTHOR]

The article describes the case of a 33-year-old South Korean man diagnosed with central serous chorioretinopathy (CSCR) following ingestion of gamma-hydroxybutyric acid (GHB) or the party drug liquid ecstasy. The patient reportedly complained of symptoms including non-improving blurred vision in the left eye for three weeks. While testing of his visual acuity turned out as unremarkable, a retinal elevation which involves the macula and centered on the fovea was revealed through fundus test.