Optic neuritis induced by Pembrolizumab treatment for recurrent vulvar cancer

JFO Open Ophthalmology Pub Date : 2025-03-22 DOI:10.1016/j.jfop.2025.100162

Ariel Cohen , Yonah Levy , Kristy Ward

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Abstract

Purpose

To describe a novel case of optic neuritis induced after pembrolizumab treatment for recurrent vulvar cancer.

Background

Immunotherapy is becoming increasingly important as a therapy for cases of vulvar cancer that are resistant to standard treatment.

Case presentation

A 53-year-old female with a history of recurrent vulvar cancer presented with sudden-onset progressive vision loss in both eyes for four weeks. Initially patient was thought to have brain metastases based on imaging, but after a thorough workup, the diagnosis of optic neuritis was made. Pembrolizumab therapy was immediately ceased, and high-dose corticosteroids were used to treat the patient effectively and reverse her symptoms.

Conclusions

Several cases of CNS toxicity and optic neuritis have been reported with the use of pembrolizumab immunotherapy but, to our knowledge, this is the first reported case to have occurred in the setting of recurrent vulvar cancer. In these cases it is important to have prompt discontinuation of the offending agent and treatment with high-dose corticosteroid course.

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派姆单抗治疗复发性外阴癌诱导视神经炎

目的报道1例复发性外阴癌经派姆单抗治疗后引起视神经炎的新病例。背景免疫疗法作为一种对标准治疗有耐药性的外阴癌的治疗方法正变得越来越重要。患者53岁，女性，既往有外阴癌复发史，因突发性进行性双眼视力丧失4周。最初，根据影像学检查，患者被认为是脑转移，但经过彻底的检查，诊断为视神经炎。立即停止派姆单抗治疗，并使用大剂量皮质类固醇有效治疗患者并逆转其症状。结论：使用派姆单抗免疫治疗已报道了几例中枢神经系统毒性和视神经炎，但据我们所知，这是第一例发生在复发性外阴癌背景下的报道。在这些情况下，重要的是要及时停药，并用大剂量皮质类固醇治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JFO Open Ophthalmology

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