雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A case of central retinal artery occlusion and neovascular glaucoma and dilation of aortic aneurysm from vasculitis during pembrolizumab treatment Yuki Yuguchi 1 , Kenya Yuki 1 , Hiroaki Ushida 1 , Kazuhiro Oiwa 2 1Department of Ophthalmology, Nagoya university hospital 2Department of Ophthalmology, Shizuoka saiseikai general hospital pp.1029-1035
Published Date 2025/8/15
DOI https://doi.org/10.11477/mf.037055790790081029
  • Abstract
  • Look Inside
  • Reference

Abstract Purpose:Pembrolizumab is an immune checkpoint inhibitor that can cause a variety of side effects. We report a case of retinal vasculitis, central retinal artery occlusion, iris ciliary inflammation in one eye and expanding aortic aneurysm during Pembrolizumab treatment.

Case:A 74-year-old man had been treated with Pembrolizumab for prostate cancer for 2 years. He was referred to our department with a chief complaint of decreased right visual acuity. The patient underwent right cataract surgery due to a right overmature cataract, but the nucleus dropped intraoperatively, so vitrectomy was added and an intraocular lens was fixed in the sulcus. His vision improved to 10/10 after the surgery, but 6 months after the surgery, he came to the outpatient clinic complaining of decreased right visual acuity and right eye pain. The patient was found to have decreased right visual acuity only to light perception, high intraocular pressure on the right, right corneal edema, anterior chamber hemorrhage, and soft exudate of the fundus. Mannitol intravenous infusion and anti-glaucoma eyedrops and oral medicine were administered, and intraocular pressure normalized but right visual acuity only improved to 1/100. Central retinal artery occlusion and neovascular glaucoma were occurred as Grade 4 immune-related adverse events by Pembrolizumab, and treatment was discontinued. Systemic corticosteroids were not administered. Later, when Pembrolizumab administration was resumed due to lymph node metastasis of the cancer, the patient's previous thoracic aortic aneurysm worsened.

Conclusion:Pembrolizumab administration can lead to retinal vasculitis and exacerbate existing aneurysms, therefore caution is required. Further expansion of indications for immune checkpoint inhibitors other than Pembrolizumab is desirable.


Copyright © 2025, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

関連文献

もっと見る

文献を共有