title: Acute visual loss after ipilimumab treatment for metastatic melanoma.
abstract: Ipilimumab, a humanized CLTA-4 antibody is a standard therapy in the treatment of advanced melanoma. While ipilimumab provides an overall survival benefit to patients, it can be associated with immune related adverse events (IrAEs).
  
  
  
  Here we describe a patient treated with ipilimumab who experienced known IrAEs, including hypophysitis, as well as a profound vision loss due to optic neuritis. There are rare reports of optic neuritis occurring as an adverse event associated with ipilimumab treatment. Furthermore, the patient experienced multiple complications from high dose steroids used to manage his IrAEs.
  
  
  
  This case highlights the need for recognition of atypical immune mediated processes associated with newer checkpoint inhibitor therapies including ipilimumab.
authors: Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA ; Present address: Division of Hematology and Medical Oncology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY USA.
authors: Melissa A
authors: MA
authors: Wilson
authors: Department of Medicine, University of Pennsylvania, Philadelphia, PA USA ; Present address: Department of Cardiology, UCSF Medical Center, San Francisco, CA USA.
authors: Kelly
authors: K
authors: Guld
authors: Department of Neurology, NYU Langone Medical Center, New York, NY USA.
authors: Steven
authors: S
authors: Galetta
authors: Departments of Ophthalmology and Neurology, Medical College of Wisconsin, Milwaukee, WI USA.
authors: Ryan D
authors: RD
authors: Walsh
authors: Division of Endocrinology, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA.
authors: Julia
authors: J
authors: Kharlip
authors: Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Health System, Philadelphia, PA USA.
authors: Madhura
authors: M
authors: Tamhankar
authors: Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA.
authors: Suzanne
authors: S
authors: McGettigan
authors: Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA.
authors: Lynn M
authors: LM
authors: Schuchter
authors: Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA ; Present address: Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, C366 MIB 1500 E. Medical Center Drive, SPC5848, Ann Arbor, MI 48109 USA.
authors: Leslie A
authors: LA
authors: Fecher
mesh_terms: D000208:Acute Disease; D000074322:Antineoplastic Agents, Immunological / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D001921:Brain / Q000473:pathology; D060908:CTLA-4 Antigen / Q000037:antagonists & inhibitors; D005451:Fluorescein Angiography; D006801:Humans; D000074324:Ipilimumab / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D009362:Neoplasm Metastasis; D009900:Optic Nerve / Q000473:pathology; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology*; D014787:Vision Tests
chemical_list: D000074322:Antineoplastic Agents, Immunological; D015415:Biomarkers; D060908:CTLA-4 Antigen; D000074324:Ipilimumab
keywords: Checkpoint inhibitors; Immune; Ipilimumab; Melanoma; Optic neuritis; Side effects