Bilateral corneal perforation in Ipilimumab/Nivolumab - associated peripheral ulcerative keratitis

PURPOSE: To present a case of immune checkpoint inhibitor-induced bilateral peripheral ulcerative keratitis that progressed to corneal perforation requiring keratoplasty in both eyes. OBSERVATIONS: We describe the course of a 60-year-old man treated with a combination of Ipilimumab and Nivolumab for...

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Detalles Bibliográficos
Autores principales: Aschauer, Julia, Donner, Ruth, Lammer, Jan, Schmidinger, Gerald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442328/
https://www.ncbi.nlm.nih.gov/pubmed/36072439
http://dx.doi.org/10.1016/j.ajoc.2022.101686
Descripción
Sumario:PURPOSE: To present a case of immune checkpoint inhibitor-induced bilateral peripheral ulcerative keratitis that progressed to corneal perforation requiring keratoplasty in both eyes. OBSERVATIONS: We describe the course of a 60-year-old man treated with a combination of Ipilimumab and Nivolumab for metastatic melanoma who presented with foreign body sensation and epiphora in both eyes. Bilateral immune-related peripheral ulcerative keratitis was refractory to topical anti-inflammatory therapy, necessitating repetitive, but unsuccessful cyanoacrylate gluing procedure followed by bilateral lamellar mini-keratoplasty. CONCLUSIONS AND IMPORTANCE: Combined immune checkpoint inhibition revokes the corneal immune privilege and can lead to auto-immune keratitis with recalcitrant progression to ulceration and perforation.

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