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Arteritic anterior ischemic optic neuropathy secondary to immune checkpoint inhibitors: A case report

Authors: Zahin Alam; Tausif Ahmed Siddiqui; Mohammed Usman Syed; Pavan K. Kottamasu; Tushar Nag; Akm Rahman;

Arteritic anterior ischemic optic neuropathy secondary to immune checkpoint inhibitors: A case report

Abstract

Ischemic optic neuropathy (ION) occurs due to insufficient blood supply to the optic nerve, with anterior ischemic optic neuropathy (AION) commonly associated with giant cell arteritis (GCA). Immune checkpoint inhibitors (ICIs), used in cancer therapy, have been linked to neuro-ophthalmic immune-related adverse events (irAEs), though the development of arteritic anterior ischemic optic neuropathy (AAION) due to ICI therapy is exceptionally rare. This case report describes a 77-year-old male with metastatic renal cell carcinoma on ICI therapy who presented with bilateral vision loss and was diagnosed with AAION. MRI findings supported GCA-AAION with orbital involvement, and the patient showed immediate but partial improvement with corticosteroids, despite a nonconfirmatory temporal artery biopsy. This case underscores the need for heightened clinical awareness of ICI-associated ocular complications and highlights the challenges in diagnosing and managing ICI-induced AAION, emphasizing the need for further research into treatment strategies to mitigate irreversible vision loss.

Keywords

Immune-related adverse effects, Immune checkpoint inhibitors, Medical physics. Medical radiology. Nuclear medicine, Neuroradiology, Arteritic ischemic optic neuropathy, R895-920, Ischemic optic neuropathy, Case Report

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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