Case | Sex | Age | Immunotherapy at onset of ocular symptoms | Presenting visual symptom(s) | Symptom onset after starting immuno-therapy | BCVA at presentation | Ocular finding(s) | Anti-retinal antibodies detected | Concurrent irAE | Treatment | Immuno-therapy cessation | Ocular outcome | Systemic outcome | Duration of follow-up (months) | |
OD | OS | ||||||||||||||
1 | F | 75–80 | One cycle of ipilimumab (3 mg/kg)+ nivolumab (1 mg/kg) | Photopsia, nyctalopia | 1 week | 6/7.5 | 6/7.5 | MAR OU | Anti-GAPDH, arrestin, anti-enolase, anti-TRPM1; anti-photoreceptor, anti-bipolar cell | Transaminitis, hypopituitarism, dermatitis, mononeuritis multiplex | Intravenous corticosteroids, intravenous immunoglobulin | Yes | Gradual visual decline with persistence of nyctalopia, 6/9 OD, 6/18 OS | CR | 34 months |
2 | F | 55–60 | Four cycles of Ipilimumab (3 mg/kg)+ nivolumab (1 mg/kg); 48 cycles of nivolumab (240 mg) | Floaters, visual field deficits | 34 months | 6/7.5 | 6/7.5 | Concentric visual field defects OU | Anti-recoverin, anti-aldolase, anti-enolase, anti-transducin-α, anti-TRPM1; anti-bipolar cell, anti-optic nerve | Pulmonary sarcoidosis-like reaction, pneumonitis | Intravenous immunoglobulin, Rituximab, plasma exchange | Yes | No change in visual field defects; 6/7.5 OD, 6/6 OS; | POD | 31 months |
3 | M | 50–55 | One cycle of ipilimumab (3 mg/kg)+ nivolumab (1 mg/kg) | Blurred vision | 2 weeks | 6/30 | 6/21 | Acute exudative polymorphous vitelliform maculopathy OU | Anti-bestrophin 1, anti-arrestin, anti-enolase, anti-transducin-α; anti-bipolar cell | Hypothyroidism, vitilligo | Posterior sub-Tenon’s corticosteroid injections | Yes | Regression of lesions; 6/6 OU | POD | 39 months |
BCVA, best-corrected visual acuity; CR, complete response; irAEs, immune-related adverse events; MAR, melanoma-associated retinopathy; OD, oculus dexter (right eye); OS, oculus sinister (left eye); OU, oculus uterque (both eyes); POD, progression of disease.