1. Association of Cancer Immunotherapy With Acute Macular Neuroretinopathy and Diffuse Retinal Venulitis.
- Author
-
Emens LA, Davis SL, Oliver SCN, Lieu CH, Reddy A, Solomon S, He L, Morley R, Fassò M, Pirzkall A, Patel H, O'Hear C, and Ferrara D
- Subjects
- Acute Disease, Adult, Antibodies, Monoclonal, Humanized, Breast Neoplasms drug therapy, Colonic Neoplasms drug therapy, Female, Fluorescein Angiography, Humans, Male, Multimodal Imaging, Retinal Diseases diagnosis, Retinal Vein pathology, Retrospective Studies, Spectrophotometry, Infrared, Tomography, Optical Coherence, Vasculitis diagnosis, Antibodies, Monoclonal adverse effects, Antineoplastic Agents adverse effects, Immunotherapy adverse effects, Retinal Diseases chemically induced, Retinal Vein drug effects, Vasculitis chemically induced
- Abstract
Importance: Checkpoint inhibition in cancer immunotherapy related to T-cell-driven mechanisms of action associated with acute macular neuroretinopathy (AMN) and diffuse retinal venulitis, an adverse event not previously described, is reported here., Objective: To describe 2 patients who developed ophthalmologic events after treatment with the programmed death 1 axis inhibitor, atezolizumab., Design, Setting, and Participants: Retrospective review of 2 patients treated with atezolizumab for metastatic breast cancer and colon cancer, respectively, who presented with AMN and diffuse retinal venulitis conducted at 2 tertiary medical centers., Main Outcomes and Measures: Multimodal imaging including near infrared, optical coherence tomography, and fluorescein angiography were used to characterize retinal vascular abnormalities., Results: Based on optical coherence tomography and multimodal imaging findings, the clinical diagnosis of AMN associated with diffuse retinal venulitis was made in these 2 patients receiving atezolizumab., Conclusions and Relevance: While only 2 cases of patients receiving the programmed death ligand 1 inhibitor atezolizumab who experienced AMN and diffuse retinal venulitis are described here, these findings suggest that patients receiving programmed death 1 axis inhibitor therapies may need to be monitored for unexpected immune-related ocular toxicity including abnormalities of the microvasculature and large retinal vessels. Further studies might investigate the potential mechanisms of retinal vascular changes associated with these therapies.
- Published
- 2019
- Full Text
- View/download PDF