Optic Neuritis Following Nivolumab Treatment for Metastatic Melanoma: A Case Report and Review of the Literature

转移性黑色素瘤患者接受纳武利尤单抗治疗后发生视神经炎:病例报告及文献复习

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Abstract

Immune checkpoint inhibitors have revolutionized the treatment of melanoma and other tumors; however, these novel drugs can trigger immune-related adverse events (irAEs), involving uncontrolled autoimmune cross-reactive damage to the brain, peripheral nerves, eyes, and connective tissue. We report an unusual case of optic neuritis and anterior uveitis following treatment with nivolumab, an anti-programmed cell death protein 1 inhibitor, in a 60-year-old Mexican woman with metastatic melanoma. We ruled out infectious, autoimmune, inflammatory, and neoplastic etiologies as the cause of optic neuritis. The patient experienced significant improvement in visual acuity and ocular pain after discontinuing nivolumab and initiating steroids with a tapered dosing regimen. When using checkpoint inhibitors, ocular and neurological symptoms should be monitored, and corticosteroid therapy can be considered a first-line treatment for patients with irAEs associated with nivolumab.

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