Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report
Introduction: Given the recent additions of immune checkpoint inhibitors (ICIs) to various cancer treatments, adverse effects, especially involving the eyes, have been on the rise. Here, we report an acute exacerbation of cancer-associated retinopathy (CAR) triggered by durvalumab treatment of small...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2024-04-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | https://beta.karger.com/Article/FullText/538246 |
| _version_ | 1797201939889389568 |
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| author | Doah Kim Jeong Kyeong Jang Youngje Sung |
| author_facet | Doah Kim Jeong Kyeong Jang Youngje Sung |
| author_sort | Doah Kim |
| collection | DOAJ |
| description | Introduction: Given the recent additions of immune checkpoint inhibitors (ICIs) to various cancer treatments, adverse effects, especially involving the eyes, have been on the rise. Here, we report an acute exacerbation of cancer-associated retinopathy (CAR) triggered by durvalumab treatment of small-cell lung cancer (SCLC). Case Presentation: An 81-year-old Asian male complained of a scotoma in the left eye after durvalumab administration, to treat SCLC. Humphrey visual field examination revealed a C-shaped temporal scotoma. Spectralis domain optical coherence tomography revealed outer retinal layer atrophy and progressive loss of the ellipsoid zone in the atrophic peripapillary area. Fundus autofluorescence (AF) images evidenced a large C-shaped hypo-AF with enhanced AF at the margin of the atrophic area, thus at the position of the scotoma. We prescribed subtenon triamcinolone injections under suspicion of CAR exacerbation, supported by positive Western blotting results for Rab6 and aldolase, and immunohistochemical staining of photoreceptor cells. The disrupted ellipsoid zone evident on OCT partially recovered, and a visual field test showed that the scotoma had improved. Conclusion: ICI-triggered exacerbation of CAR should be considered in SCLC patients before ICI treatment commences; an optimal treatment should preserve functional vision. |
| first_indexed | 2024-04-24T07:55:31Z |
| format | Article |
| id | doaj.art-e6422d0e16ac45f7ad9950257c4fa8dc |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-04-24T07:55:31Z |
| publishDate | 2024-04-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-e6422d0e16ac45f7ad9950257c4fa8dc2024-04-18T07:17:48ZengKarger PublishersCase Reports in Ophthalmology1663-26992024-04-0115134335210.1159/000538246538246Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case ReportDoah Kim0Jeong Kyeong Jang1Youngje Sung2Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of KoreaDepartment of Ophthalmology, Catholic University of Korea Yeouido Saint Mary’s Hospital, Seoul, Republic of KoreaDepartment of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of KoreaIntroduction: Given the recent additions of immune checkpoint inhibitors (ICIs) to various cancer treatments, adverse effects, especially involving the eyes, have been on the rise. Here, we report an acute exacerbation of cancer-associated retinopathy (CAR) triggered by durvalumab treatment of small-cell lung cancer (SCLC). Case Presentation: An 81-year-old Asian male complained of a scotoma in the left eye after durvalumab administration, to treat SCLC. Humphrey visual field examination revealed a C-shaped temporal scotoma. Spectralis domain optical coherence tomography revealed outer retinal layer atrophy and progressive loss of the ellipsoid zone in the atrophic peripapillary area. Fundus autofluorescence (AF) images evidenced a large C-shaped hypo-AF with enhanced AF at the margin of the atrophic area, thus at the position of the scotoma. We prescribed subtenon triamcinolone injections under suspicion of CAR exacerbation, supported by positive Western blotting results for Rab6 and aldolase, and immunohistochemical staining of photoreceptor cells. The disrupted ellipsoid zone evident on OCT partially recovered, and a visual field test showed that the scotoma had improved. Conclusion: ICI-triggered exacerbation of CAR should be considered in SCLC patients before ICI treatment commences; an optimal treatment should preserve functional vision.https://beta.karger.com/Article/FullText/538246cancer-associated retinopathydurvalumabimmune checkpoint inhibitorimmune retinopathy |
| spellingShingle | Doah Kim Jeong Kyeong Jang Youngje Sung Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report Case Reports in Ophthalmology cancer-associated retinopathy durvalumab immune checkpoint inhibitor immune retinopathy |
| title | Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report |
| title_full | Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report |
| title_fullStr | Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report |
| title_full_unstemmed | Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report |
| title_short | Sight-Threatening Immune Retinopathy Developing Secondary to Durvalumab Treatment of Small-Cell Lung Cancer: A Case Report |
| title_sort | sight threatening immune retinopathy developing secondary to durvalumab treatment of small cell lung cancer a case report |
| topic | cancer-associated retinopathy durvalumab immune checkpoint inhibitor immune retinopathy |
| url | https://beta.karger.com/Article/FullText/538246 |
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