May 31, 2019 Conference

  


Title
Risk Factors for Poor Visual Outcomes in Patients That Develop Uveitis After Treatment with Checkpoint Inhibitors

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Author(s)
Marez Megalla, Yale Ophthalmology (Presenter)
Harriet Kluger, Yale Smilow Cancer Center
Sarah Weiss, Yale Smilow Cancer Center
Renelle Pointdujour-Lim, Yale Ophthalmology
Dr. Ninani Kombo, Yale Department of Ophthalmology and Visual Science
Abstract

Purpose 
There have been several reports in the literature of uveitic entities developing in patients undergoing treatment with checkpoint inhibitors. We performed a retrospective chart review of patients who were treated with these powerful agents to assess for risk factors for severe vision loss after uveitis.

Methods 
A retrospective chart review was performed. Patients treated with checkpoint inhibitors were identified and their charts analyzed to determine if any risk factors existed among patients taking these medications who developed uveitis. Ophthalmic and personal history was assessed as were types of uveitis, responsiveness to treatment, and visual outcomes.

Results 
Age and sex was found to be evenly distributed among patients that developed poor visual outcomes after being treated with checkpoint inhibitors. Patients with good visual outcomes were more often non-smokers and overwhelmingly carried a diagnosis of cutaneous metastatic melanoma compared to those with poor visual outcomes that were more likely to have unknown primary or non-cutaneous melanoma primary. Multiple systemic immune-related adverse events from the medications were associated with poor visual outcomes. Uveitis that proved challenging to control requiring multiple treatment modalities was also associated with poorer visual outcomes.

Conclusions 
Patients treated with checkpoint inhibitors who developed uveitis were more likely to experience multiple systemic immune-related adverse events. Patients found to have severe uveitis were more likely to have poor visual outcomes.