Hypotony and Anterior Uveitis following Dual Therapy with Nivolumab and Ipilimumab for Metastatic Melanoma: A Case Report

Abstract

Purpose: To describe a rare case of hypotony and anterior uveitis following dual therapy with nivolumab and ipilimumab for metastatic melanoma. Methods: Case report. Results: Here, we present the case of a 64-year-old man taking nivolumab and ipilimumab dual therapy for BRAF+ (v-raf murine sarcoma viral oncogene homolog B1) metastatic melanoma. After treatment for 3 months, he presented to the ophthalmology clinic with bilateral intraocular pressures of 1 mmHg, bilateral keratic precipitates, cataracts, posterior synechiae, and anterior chamber inflammation. He improved with topical medications and the cessation of immunotherapy. Conclusions: Immunotherapies are a novel class of chemotherapy that has increased in prevalence for the treatment of numerous malignancies. There are many rare complications from these medications that are sparsely reported. Knowledge of ocular hypotony as a potential consequence of nivolumab and ipilimumab is important, particularly as it may arise months after treatment initiation and necessitate immunotherapy cessation.