Pembrolizumab-Induced Nodular Posterior Scleritis

J Vitreoretin Dis. 2023 Apr 10;7(4):348-351. doi: 10.1177/24741264231163396. eCollection 2023 Jul-Aug.

Abstract

Purpose: To report a case of painless posterior scleritis presenting as a choroidal nodule in a patient with history of a tumor being treated with pembrolizumab. Methods: A case and its findings were analyzed, and a relevant literature review was performed. Results: A 20-year-old woman with a history of ependymoma presented with painless blurred vision in the right eye after being started on pembrolizumab for a tumor recurrence. Fundoscopy showed a solitary amelanotic choroidal lesion with surrounding subretinal fluid in the affected eye. Ultrasonography showed moderate internal reflectivity and fluid in Tenon capsule consistent with nodular posterior scleritis. After a course of systemic steroids and discontinuation of the pembrolizumab, the choroidal lesion completely resolved. Conclusions: Clinicians should be aware of posterior scleritis as an ocular complication of this class of medications.

Keywords: checkpoint inhibitors; pembrolizumab; scleritis; uveitis.

Publication types

  • Case Reports