Annular choroidal detachment following intravitreal aflibercept injection in a patient with nivolumab treatment: a case report.

Anti-VEGF antibody Choroidal detachment Immune checkpoint inhibitor PD-1 Vogt-Koyanagi-Harada disease

Journal

BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802

Informations de publication

Date de publication:
08 Dec 2022
Historique:
received: 16 03 2022
accepted: 26 11 2022
entrez: 9 12 2022
pubmed: 10 12 2022
medline: 15 12 2022
Statut: epublish

Résumé

To present a novel case that developed annular choroidal detachment after intravitreal anti-vascular endothelial growth factor antibody injection in a patient after immune checkpoint inhibitor treatment. A 58-year-old Japanese man presented visual impairment in the right eye. Ophthalmological examination revealed macular edema in the right eye, which suggested the possibility of age-related macular degeneration. Following the intravitreal aflibercept injection, the annular choroidal detachment was observed in the injected eye. As hypotony or thick sclera was not observed, choroidal detachment seemed to have appeared due to enhanced inflammation by intravitreal injection. The patient had a history of stage IV paranasal cavity cancer and was treated with nivolumab, an immune checkpoint inhibitor. The immune response might have been enhanced due to the use of nivolumab so that intravitreal injection triggered inflammation. Three weeks after sub-tenon injection of triamcinolone acetonide, macular edema and choroidal detachment improved. Intravitreal aflibercept injection caused annular choroidal detachment in our patient, presumably because the immune system was activated after nivolumab treatment. To the best of our knowledge, this is the first case report of annular choroidal detachment that developed after intravitreal injection in a patient with a history of nivolumab therapy. With the increasing use of immune checkpoint inhibitors in patients with various cancers, clinicians should be aware of these potentially associated immune-related adverse events.

Sections du résumé

BACKGROUND BACKGROUND
To present a novel case that developed annular choroidal detachment after intravitreal anti-vascular endothelial growth factor antibody injection in a patient after immune checkpoint inhibitor treatment.
CASE PRESENTATION METHODS
A 58-year-old Japanese man presented visual impairment in the right eye. Ophthalmological examination revealed macular edema in the right eye, which suggested the possibility of age-related macular degeneration. Following the intravitreal aflibercept injection, the annular choroidal detachment was observed in the injected eye. As hypotony or thick sclera was not observed, choroidal detachment seemed to have appeared due to enhanced inflammation by intravitreal injection. The patient had a history of stage IV paranasal cavity cancer and was treated with nivolumab, an immune checkpoint inhibitor. The immune response might have been enhanced due to the use of nivolumab so that intravitreal injection triggered inflammation. Three weeks after sub-tenon injection of triamcinolone acetonide, macular edema and choroidal detachment improved.
CONCLUSIONS CONCLUSIONS
Intravitreal aflibercept injection caused annular choroidal detachment in our patient, presumably because the immune system was activated after nivolumab treatment. To the best of our knowledge, this is the first case report of annular choroidal detachment that developed after intravitreal injection in a patient with a history of nivolumab therapy. With the increasing use of immune checkpoint inhibitors in patients with various cancers, clinicians should be aware of these potentially associated immune-related adverse events.

Identifiants

pubmed: 36482328
doi: 10.1186/s12886-022-02714-2
pii: 10.1186/s12886-022-02714-2
pmc: PMC9733300
doi:

Substances chimiques

Nivolumab 31YO63LBSN
Immune Checkpoint Inhibitors 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

476

Informations de copyright

© 2022. The Author(s).

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Auteurs

Maho Sato (M)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan. satomahoq@gmail.com.
Department of Ophthalmology, Keio University, Tokyo, Japan. satomahoq@gmail.com.

Hirohisa Kubono (H)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Kazuya Yamashita (K)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Takashi Nagamoto (T)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Yoshiko Ofuji (Y)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Saki Sakakura (S)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Ryuki Fukumoto (R)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Seiichiro Hata (S)

Yokohama Sky Eye Clinic, Yokohama, Kanagawa, Japan.

Mari Kawamura (M)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

Kotaro Suzuki (K)

Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishiku, Yokohama, Kanagawa, Japan.

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