Progressive choroidal thinning (leptochoroid) and fundus depigmentation associated with checkpoint inhibitors Journal Article

   


Authors: Canestraro, J.; Jaben, K. A.; Wolchok, J. D.; Abramson, D. H.; Francis, J. H.
Article Title: Progressive choroidal thinning (leptochoroid) and fundus depigmentation associated with checkpoint inhibitors
Abstract: Purpose: To report asymptomatic progressive fundus depigmentation and choroidal thinning in the absence of intraocular inflammation in a patient treated with checkpoint inhibitors. Observations: A 69-year-old woman with metastatic cutaneous melanoma, treated with checkpoint inhibition (nivolumab, ipilimumab and pembrolizumab), developed asymptomatic progressive fundus depigmentation associated with choroidal thinning in both eyes over 26 months. Serial multimodal imaging was obtained over the study period including fundus photography, fundus autofluorescence and optical coherence tomography (OCT). Over 26 months, the central choroidal thickness decreased by 34% (from 270μm to 92μm, mean between both eyes). Concurrently, central retinal thickness remained stable (206μm to 214μm, mean between both eyes). There were no findings of intraocular inflammation, subretinal fluid or retinal pigment epithelium disturbance. The patient reported no visual symptoms and maintained a visual acuity of 20/25+ in the right eye and 20/30 in the left eye throughout the observation period. Concurrently, cutaneous vitiligo and poliosis, inclusive of her periorbital dermis and eyelashes also developed. Conclusions and importance: Progressive fundus depigmentation and choroidal thinning can be observed with checkpoint inhibition in the absence of intraocular inflammation. © 2020
Keywords: clinical article; aged; gene mutation; case report; monotherapy; treatment duration; follow up; disease association; ipilimumab; liver metastasis; lung metastasis; brain metastasis; anxiety disorder; intraocular pressure; hypercholesterolemia; atorvastatin; escitalopram; sclerosis; cutaneous melanoma; optical coherence tomography; medical history; visual acuity; depigmentation; vitiligo; subretinal fluid; multimodal imaging; autofluorescence; nivolumab; blepharitis; fluorometholone; cancer; human; female; article; checkpoint inhibitor; pembrolizumab; retinal pigment epithelium; choroid disease; best corrected visual acuity; choroidal thickness; fundus vitiligo; leptochoroid; poliosis; progressive choroidal thinning; central retinal thickness; choroidal thinning; eye inflammation; fundus depigmentation; internal limiting membrane
Journal Title: American Journal of Ophthalmology Case Reports
Volume: 19
ISSN: 2451-9936
Publisher: Elsevier Inc.  
Date Published: 2020-09-01
Start Page: 100799
Language: English
DOI: 10.1016/j.ajoc.2020.100799
PROVIDER: scopus
PMCID: PMC7329928
PUBMED: 32637735
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087017748&doi=10.1016%2fj.ajoc.2020.100799&partnerID=40&md5=44ddc6e08ba82a6cf01fa56dbec592c6
Notes: Article -- Export Date: 3 August 2020 -- Source: Scopus
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MSK Authors
  1. Jedd D Wolchok
    905 Wolchok
  2. Jasmine Helen Francis
    256 Francis
  3. David H Abramson
    389 Abramson
  4. Korey A. Jaben
    7 Jaben
  5. Julia Canestraro
    27 Canestraro
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