Immune Checkpoint Inhibitor-associated Uveitis: Review of Treatments and Outcomes

Ocul Immunol Inflamm. 2021 Jan 2;29(1):203-211. doi: 10.1080/09273948.2020.1781902. Epub 2020 Aug 20.

Abstract

Purpose: Immune checkpoint inhibitors (ICPIs), novel immunotherapy agents employed in the treatment of metastatic melanoma and other solid tumors, are associated with immune-related adverse events, including ocular inflammation. We review the current literature on immune checkpoint inhibitor-associated uveitis (ICIPU).Methods: A comprehensive literature review utilizing MEDLINE/PubMed, Cochrane, and Web of Science databases was conducted. One hundred and twenty-six cases of ICPIU reported in the literature prior to January 31, 2020 were identified and reviewed.Results: ICPIs were associated with 126 cases of anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis from 67 reports in the literature. Patients typically developed intraocular inflammation a median of 9 weeks after initiation of ICPI and 83.6% of the patients developed uveitis within 6 months. The vast majority of patients recovered to within one line of baseline vision in response to topical, local, and/or systemic steroid treatment as well as the cessation of medication.Conclusions: Prompt recognition and steroid treatment of ICPIU are critical to the care of patients receiving ICPIs.

Keywords: CTLA-4 inhibitor; Immune checkpoint inhibitor; PD-1 inhibitor; PD-L1 inhibitor; atezolizumab; avelumab; cemiplimab; durvalumab; ipilimumab; nivolumab; pembrolizumab; uveitis.

Publication types

  • Review

MeSH terms

  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy / adverse effects*
  • Uveitis / drug therapy

Substances

  • Immune Checkpoint Inhibitors