title: Retinal vasculitis and ocular vitreous metastasis following complete response to PD-1 inhibition in a patient with metastatic cutaneous melanoma.
abstract: We report on a 36-year-old woman treated with the anti PD-1 antibody Pembrolizumab for metastatic cutaneous melanoma in the first line setting. She achieved a complete response and then relapsed with metastases to the vitreous cavity with an associated angiographically determined retinal vasculitis. Vitreous metastasis without choroidal involvement is unusual and may be due to individual cell extravasation, vitreous hemorrhage containing malignant cells, or direct spread through the optic nerve. This finding highlights the need for immune sanctuary sites to be monitored in the presence of PD-1 inhibition and we hypothesize that the use of PD-1 inhibitor potentiated the patient's angiographically determined retinal vasculitis.
authors.affiliation: University of Toronto Department of Ophthalmology and Vision Sciences, University Health Network/Toronto Western Hospital, 399 Bathurst Street, 6 East Room 415, Toronto, Ontario M5T 2S8 Canada.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Manusow
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
authors.forename: Leila
authors.initials: L
authors.lastname: Khoja
authors.affiliation: University of Toronto Department of Ophthalmology and Vision Sciences, University Health Network/Toronto Western Hospital, 399 Bathurst Street, 6 East Room 415, Toronto, Ontario M5T 2S8 Canada.
authors.forename: Nataly
authors.initials: N
authors.lastname: Pesin
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Joshua
authors.affiliation: University of Toronto Department of Ophthalmology and Vision Sciences, University Health Network/Toronto Western Hospital, 399 Bathurst Street, 6 East Room 415, Toronto, Ontario M5T 2S8 Canada.
authors.forename: Efrem D
authors.initials: ED
authors.lastname: Mandelcorn
keywords: Melanoma; Melanoma-associated Retinopathy (MAR); PD-1 inhibitor; Retinal vasculitis; Vitreous metastasis