Case Report - Journal of Clinical Ophthalmology (2019) Volume 3, Issue 2
Pembrolizumab-associated diplopia secondary to idiopathic orbital inflammatory syndrome
Purpose: To report a case of pembrolizumab-associated idiopathic orbital inflammatory syndrome
Observations: A 57 year-old female with a history of metastatic non-small cell lung cancer treated with
radiation therapy and pembrolizumab presented with acute onset of painful horizontal diplopia on
right gaze. MRI Orbits and Brain revealed new diffuse enhancement and enlargement of the right
lateral rectus muscle that had not been present on imaging six weeks prior. The patient was presumed
to have IOIS and was started on oral steroid therapy, which lead to resolution of symptoms.
Conclusion and importance: This is the first reported case of pembrolizumab-associated IOIS.
Discovery, recognition, and treatment of ophthalmologic side effects of pembrolizumab are necessary
for vision preservation in cancer patients who may benefit from the medication.
Author(s): Kristi L Michels, Achilles G Karagianis, Nicholas J Volpe, Shira S Simon