Immune Checkpoint Inhibitors Linked With Extensive Adverse Ocular Events

Retina of diabetic - diabetic retinophaty
Retina of diabetic – diabetic retinophaty
The complications were most commonly seen in patients taking ipilimumab.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


Patients with advanced malignancies who have been treated with immune checkpoint inhibitors (ICI) have improved systemic prognosis, but may be at risk of developing extensive ocular immune-related adverse events (irAEs), according to study results presented at the American Academy of Ophthalmology 2021 Annual Meeting, held in New Orleans from November 12-15. 

The investigators identified the characteristics of ocular irAEs, which can be sight threatening, and detailed the management and clinical outcomes of these events at a U.S. tertiary cancer center. They retrospectively reviewed records of 1280 patients who presented between 2010 and 2019. The team identified 193 patients who developed irAEs (15%) (51% men). Adverse ocular events included corneal toxicity (29%), uveitis (16%), neuro-ophthalmic issues (13%), retinopathy (13%), and others (13%). IrAEs were most commonly associated with ipilimumab treatment. 

Most irAEs of grade I-II were treated topically; however, advanced cases required system corticosteroids and in some cases termination of ICI treatment. 

The results presented here constitute the largest case study to date detailing the increased risk of ocular toxicity that is associated with ICI treatment of advanced cancers. 

Visit Ophthalmology Advisor’s conference section for the complete Focus on Retina coverage from the AAO 2021.



Mazharuddin AA, Gombos DS, Patel NA, Al-Zubidi N. Highlights on ocular adverse effects of checkpoint inhibitor immunotherapy at U.S. tertiary cancer center. Paper presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA056.