Complete color vision loss in a patient with metastatic melanoma of the skin treated with nivolumab-relatlimab.

IF 1 4区 医学 Q4 ONCOLOGY
Ruba Alchaikh Hassan, Anderson Vu, Henry Tsai, Constantin A Dasanu
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引用次数: 0

Abstract

IntroductionThe combination nivolumab-relatlimab has demonstrated therapeutic benefits for patients with metastatic melanoma. However, its adverse effects can affect various organs, including the eye.Case reportWe present the case of an 80-year-old man who developed complete color blindness after the 2nd dose of nivolumab-relatlimab for advanced cutaneous melanoma. He also had significant blurry vision. Fundoscopy identified bilateral serous macular detachment. Ocular coherence tomography confirmed serous infiltration within the macula. After a thorough investigation, causality assessment linked this retinal effect to nivolumab-relatlimab (probable relationship via Naranjo criteria).Management and outcomeThe patient was treated with corticosteroids, intravenous immunoglobulin (IVIG), rituximab, and plasmapheresis, with improvement in blurry vision. However, he continued to experience persistent absence of color perception ("black and white vision") at a follow-up visit six months later.Discussion/conclusionFurther studies are necessary to understand the exact pathophysiology of this process. We hypothesize that it involves direct toxicity to the photoreceptors or retinal ganglion cells, leading to irreversible color vision loss. Effective strategies for preventing this significant, life-changing toxic effect of nivolumab-relatlimab should be sought.

用尼伏单抗治疗的皮肤转移性黑色素瘤患者的完全色视力丧失。
nivolumab- relatlimumab联合治疗转移性黑色素瘤已被证实有治疗效果。然而,它的副作用会影响包括眼睛在内的各种器官。病例报告:我们报告了一例80岁的男性患者,在接受第二次尼伏单抗治疗晚期皮肤黑色素瘤后出现完全色盲。他的视力也很模糊。眼底镜检查发现双侧浆液性黄斑脱离。眼相干断层扫描证实黄斑内有浆液浸润。经过彻底的调查,因果关系评估将这种视网膜效应与纳鲁单抗-相关单抗联系起来(根据纳兰霍标准可能存在关系)。治疗和结果患者接受皮质类固醇、静脉注射免疫球蛋白(IVIG)、利妥昔单抗和血浆置换治疗,视力模糊得到改善。然而,在六个月后的随访中,他继续经历持续的颜色感知缺失(“黑白视觉”)。讨论/结论需要进一步的研究来了解这一过程的确切病理生理。我们假设它涉及直接毒性光感受器或视网膜神经节细胞,导致不可逆的色觉丧失。应该寻求有效的策略来预防nivolumab- relatlimumab这种显著的、改变生命的毒性作用。
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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来源期刊
CiteScore
2.70
自引率
7.70%
发文量
276
期刊介绍: Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...
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