Recurrent sympathetic-ophthalmia
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Pembrolizumab: case report A 77-year-old man developed recurrent sympathetic ophthalmia during treatment with pembrolizumab for metastatic lung cancer. The man, presented with reduced vision of counting finger in his left eye. He lost his right eye vision after the perforated corneal ulcer surgery performed 20 months prior to the presentation. Subsequently, perforation surgery of the right eye was performed. Four months after the right eye perforation surgery, he developed choroidal thickening and exudative retinal detachment with multiple leaking points. He was diagnosed with sympathetic ophthalmia. He was treated with unspecified systemic steroid and cyclosporine with improvement in vision. Four months before the current presentation, he was diagnosed with small-cell lung cancer (T4N3M1) with bone metastasis, for which he was started on pembrolizumab therapy [dosage and route not stated]. After three infusions (46 days, 25 days and 3 days before the current presentation), he noticed severe visual impairment of counting fingers in his left eye. Intraocular pressure in the left eye was 9 mmHg. Fundus examination revealed extensive annular choroidal detachment in all four quadrants. Slit-lamp examination demonstrated 1+ vitreous and 1+ anterior chamber inflammation with mutton-fat keratic precipitates. Fundus examination demonstrated extensive annular choroidal detachment in all the four quadrants. Fluorescein angiography revealed disc and surrounding vessels leakages. Intraretinal and subretinal fluid involving fovea with choroidal wrinkling and thickening was confirmed based on spectral-domain optical coherence tomography. B-scan ultrasonography demonstrated serous choroidal detachment. Intraocular masses were not observed. Based on these findings, he was diagnosed with recurrent sympathetic ophthalmia. The man’s pembrolizumab treatment was discontinued, and he was treated with prednisolone acetate with slow taper. Three months later, a complete resolution of subretinal fluid and uveal effusion was observed with a visual acuity of 20/125. Lee J, et al. Recurrent Sympathetic Ophthalmia with Annular Choroidal Detachment after Pembrolizumab Treatment: A Case Report. Ocular Immunology and Inflammation 803504141 28: 864-867, No. 6, 17 Aug 2020. Available from: URL: http://doi.org/10.1080/09273948.2019.1604975
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Reactions 3 Oct 2020 No. 1824
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