Ocular Inflammatory Complications of Treatment for Metastatic Melanoma

Ocul Immunol Inflamm. 2023 Oct;31(8):1669-1673. doi: 10.1080/09273948.2022.2098147. Epub 2022 Aug 1.

Abstract

Purpose: To characterize various ocular inflammatory complications arising from metastatic cutaneous melanoma therapies and their management.

Methods: Retrospective case series of patients who were referred to a tertiary uveitis practice for ophthalmic exam All patients received targeted metastatic cutaneous melanoma treatment, including BRAF/MEK inhibitors and various immunotherapies.

Results: 109 patients were identified, with 43 (39.4%) having 65 definitive instances of OIAE. Sixteen different OIAE were identified. Ipilimumab monotherapy and ipilimumab/nivolumab combination therapy were most commonly associated. Anterior uveitis was the most common OIAE (18/65, 27.7%). Thirty patients (69.8%) were managed with observation or topical steroid therapy. Only 4 patients required further therapies for OIAE, with one patient not attaining resolution.

Conclusions and relevance: While a broad range of OIAE was identified, most were not vision-threatening and did not require discontinuation of the associated therapy.

Keywords: BRAF; MEK; immunotherapies; metastatic melanoma; ocular inflammation.

Plain language summary

Question: What is the scope of ocular inflammatory complications from metastatic melanoma therapies?

Findings: In this retrospective chart review, 43 patients with definitive ocular inflammatory adverse effects(OIAE) were identified from 109 total patients on therapy for metastatic melanoma. Sixteen different OIAE were identified.Meaning: Ophthalmologists managing ocular complications from melanoma treatments should be aware of the broad, but usually mild, scope of possible complications.

MeSH terms

  • Humans
  • Ipilimumab / adverse effects
  • Melanoma* / drug therapy
  • Melanoma* / secondary
  • Melanoma, Cutaneous Malignant
  • Protein Kinase Inhibitors
  • Retrospective Studies
  • Skin Neoplasms* / drug therapy
  • Skin Neoplasms* / pathology

Substances

  • Ipilimumab
  • Protein Kinase Inhibitors