J Korean Ophthalmol Soc.  2024 Jun;65(6):394-399. 10.3341/jkos.2024.65.6.394.

Exudative Retinal Detachment after Pembrolizumab Treatment in Metastatic Cutaneous Melanoma

• Lee SH
• Choi YS
• Kim JY
• Kim YM
• Do JR
• Kang YK
• Park DH
• Shin JP

• KMID: 2556383
• DOI: http://doi.org/10.3341/jkos.2024.65.6.394

Abstract

Purpose
To report a case of exudative retinal detachment after using pembrolizumab in a patient with metastatic cutaneous melanoma.
Case summary
A 67-year-old woman, diagnosed with malignant melanoma of the right thumb and axillary metastasis, presented with bilateral visual disturbance 3 days after adjuvant chemotherapy with pembrolizumab. Her best corrected visual acuity was 0.2 in the right eye and 0.7 in the left, while the intraocular pressure was 14 mmHg in both eyes. Fundus examination showed serous retinal detachment and choroidal detachment in the right eye, as well as a chorioretinal folding in both eyes. Optical coherence tomography showed exudative retinal detachment and choroidal detachment in the right eye, along with choroidal folding in both eyes. The pembrolizumab was stopped immediately, and the patient began treatment with systemic and topical steroids. After 1 month, the visual acuity improved and there was no exudative retinal detachment or choroidal detachment. However, 3 weeks later, exudative retinal detachment recurred in both eyes. The patient started treatment with oral steroids and cyclosporine, which resulted in the resolution of the exudative retinal detachment after 1 month.
Conclusions
Exudative retinal detachment may occur as a side effect of pembrolizumab treatment. Therefore, a differential diagnosis and appropriate treatment of ocular side effects are necessary.

Keyword

Immune checkpoint inhibitor, Pembrolizumab, Retinal detachment