Iatrogenic affectation of ocular motility by immune checkpoint inhibitors

Cancer therapy relies on new antitumoral drugs called immune checkpoint inhibitors (ICI), which produce long-lasting anti-tumor responses and lengthen survival, but cause autoimmune-type toxicity. The clinical characteristics induced by ICI are not well characterized to date and careful collection o...

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Bibliographic Details
Published inArchivos de la Sociedad Española de Oftalmología (English ed.)
Main Authors Fernández Jiménez-Ortiz, H, Maroto Rodríguez, B, Lapuente Monjas, R, Sampedro Yáñez, R, Sánchez Santos, I, Toledano Fernández, N
Format Journal Article
LanguageEnglish
Published Spain 25.11.2023
Subjects
Inhibidores del punto de control
Diplopia
Immune checkpoint inhibitors
Neuro-oftalmología
Neuro-ophthalmology
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Summary:Cancer therapy relies on new antitumoral drugs called immune checkpoint inhibitors (ICI), which produce long-lasting anti-tumor responses and lengthen survival, but cause autoimmune-type toxicity. The clinical characteristics induced by ICI are not well characterized to date and careful collection of clinical data is required to accurately define its safety profile. We conducted a literature search in the main clinical search engines to identify pharmacological ocular iatrogenic events of ICIs related to ocular motility. Four systematic reviews were found that included this type of ocular iatrogenesis as well as numerous isolated case reports. Reported adverse effects include: oculomotor paresis, optic neuropathy, optic atrophy, myastheniform syndromes, thyroid pseudo-orbitopathy, orbital apex syndrome, and hypophysitis. Most were managed without interruption or with partial interruption of cancer treatment. Aggressive systemic treatments were required for adequate management of ocular iatrogenic events. It is essential that the ophthalmologist become familiar with the new ICI oncological treatments, capable of causing severe and disabling motilidad ocular iatrogenesis for the patient. The communication of adverse effects and the report of the treatments used can help the most appropriate management of these patients. Research should be oriented towards complex differential diagnosis and to optimize decisions on cancer treatments.
ISSN:2173-5794