摘要
免疫检查点抑制剂(ICI)作为一种新型靶向治疗药物,在癌症治疗中展示出持久的疗效.然而,部分接受ICI治疗的患者可能会遭受免疫相关不良事件(irAE)的影响.相较于皮肤组织、胃肠道系统等的irAE,神经眼科传出系统的irAE则较为罕见.已报道的神经眼科传出系统irAE主要包括重症肌无力、眼眶眼外肌炎、类甲状腺相关眼病、核间性眼肌麻痹、Miller-Fisher综合征、颅神经不良事件.探讨神经眼科传出系统irAE的可能机制及潜在干预措施对于预测患者irAE风险、制定预防措施以及实施更为有效的临床治疗至关重要.本综述旨在总结神经眼科传出系统irAE的发生机制、临床特征及防治措施,以助于眼科医生和肿瘤科医生早期诊断和管理此类病患.
Abstract
Immune checkpoint inhibitors(ICI),as a new type of targeted therapeutic drugs,have demonstrated durable efficacy in cancer treatment.However,some patients receiving ICI treatment may be affected by immune-related adverse events(irAE).Compared with irAE in skin tissues,gastrointestinal system,etc.,irAE in the neuro-ophthalmic efferent system are relatively rare.The reported irAE in the neuro-ophthalmic efferent system mainly include myasthenia gravis,orbital extraocular myositis,thyroid-associated ophthalmopathy-like conditions,internuclear ophthalmoplegia,Miller-Fisher syndrome,and cranial nerve adverse events.Exploring the possible mechanisms and potential intervention measures of irAE in the neuro-ophthalmic efferent system is crucial for predicting the risk of irAE in patients,formulating preventive measures,and implementing more effective clinical treatments.This review aims to summarize the occurrence mechanisms,clinical features,and prevention and treatment measures of irAE in the neuro-ophthalmic efferent system,so as to assist ophthalmologists and oncologists in the early diagnosis and management of such patients.
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