Sunset Glow Fundus and Bilateral Choroidal Neovascularization in a Pediatric Patient Receiving Nivolumab: A Rare Pediatric Immune-Related Ocular Complication.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2025-07-01 DOI:10.1080/09273948.2025.2524584

Izlem Ozturan, Sibel Kadayifcilar, Figen Bezci Aygun, Tezer Kutluk

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引用次数: 0

Abstract

Purpose: To report a rare case of immune checkpoint inhibitor (ICI)- associated bilateral choroidal neovascularization (CNV) and sunset glow fundus appearance in a pediatric patient receiving long-term nivolumab therapy.

Method: Observational case report.

Case report: A 15-year-old male with metastatic myoepithelial carcinoma, on nivolumab for 2.5 years, presented with bilateral blurred vision. Fundus examination revealed a sunset glow fundus, punched-out lesions, and CNV in both eyes. Optical coherence tomography (OCT) confirmed inflammatory CNV with choroidal thickening. Nivolumab was discontinued, and the patient received systemic corticosteroids and intravitreal ranibizumab. Despite initial improvement, CNV recurred upon steroid tapering, requiring additional anti-VEGF injections. At four months, vision stabilized with no CNV reactivation.

Conclusion: This case represents the first pediatric report of ICI- associated bilateral CNV and sunset glow fundus appearance. It underscores the importance of monitoring for late-onset immune-related ocular complications in patients on long-term nivolumab therapy.

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接受纳武单抗的儿童患者的晚霞眼底和双侧脉络膜新生血管：一种罕见的儿童免疫相关眼部并发症。

目的：报告一个罕见的病例免疫检查点抑制剂（ICI）相关的双侧脉络膜新生血管（CNV）和晚霞眼底出现在儿科患者接受长期纳沃单抗治疗。方法：观察性病例报告。病例报告：一名15岁男性转移性肌上皮癌，纳武单抗治疗2.5年，表现为双侧视力模糊。眼底检查显示眼底呈晚霞状，病灶突出，双眼CNV。光学相干断层扫描（OCT）证实炎性CNV伴脉络膜增厚。停用尼武单抗，患者接受全身皮质类固醇和玻璃体内雷尼单抗治疗。尽管最初有所改善，但在类固醇逐渐减少后CNV复发，需要额外注射抗vegf。4个月时，视力稳定，无CNV再激活。结论：本病例是第一例ICI相关的双侧CNV和晚霞眼底表现的儿科报告。它强调了监测长期接受纳武单抗治疗的患者迟发性免疫相关眼部并发症的重要性。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.