The following is a summary of “Ophthalmic Immune-Related Adverse Events and Association with Survival: Results from a Real-World Database,” published in the September 2024 issue of  Ophthalmology by Quiruz et al.

Researchers conducted a retrospective study to assess ophthalmic immune-related adverse events (irAEs) after immune checkpoint inhibitor (ICI) treatment and their influence on prevailing survival in real-world data.

They collected data from TriNetX, an electronic health records database. Patients with ophthalmic irAEs were included within a year after starting immunotherapy, and those with known ocular toxicities 6 months before treatment were excluded. Individuals were compared with controls using scores based on demographics and cancer type. A Cox proportional hazard model estimated hazard ratios and Kaplan-Meier survival analysis with the log-rank test evaluated ophthalmic irAE development within 12 months.

The results showed 41,020 patients (57.4% male, mean age 65.2±11.9 years) with 5 most common ophthalmic irAEs, which were dry eye syndrome (2%), conjunctivitis (0.87%), blepharitis (0.51%), anterior uveitis (0.39%), and keratitis (0.38%). Dry eye syndrome was familiar in all immunotherapy classes. CTLA-4 inhibitors plus PD-1 inhibitors and CTLA-4 inhibitors had higher anterior uveitis rates (1.39% and 1.29%, respectively) than PD-1 inhibitors (0.27%) and PD-L1 inhibitors (0.14%) within a year. A 12-month landmark analysis had reduced survival for any ophthalmic irAE (HR, 1.37; 95% CI, 1.20-1.56; P<0.0001), neuro-ophthalmic irAE (HR, 1.53; 95% CI, 1.09-2.14; P =0.0124), and cornea and ocular surface irAE (HR, 1.34; 95% CI, 1.15-1.56; P< 0.0001).

They concluded anterior segment ophthalmic irAEs were more frequent than posterior segment and may be linked with declined survival, presenting aggressive management for therapy.

Source: ajo.com/article/S0002-9394(24)00416-1/abstract