免疫检查点抑制剂相关神经眼科传出系统免疫相关不良事件表现与防治的研究进展  

Research progress on the manifestations prevention and treatment of immune-related adverse events in the neuro-ophthalmic efferent system related to immune checkpoint inhibitors

作　　者：金淼 姜利斌 Jin Miao;Jiang Libin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心、北京市眼科研究所、北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华眼科杂志》2025年第1期71-76,共6页Chinese Journal of Ophthalmology

基　　金：北京市自然科学基金(7222028)。

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。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.

关 键 词：免疫检查点抑制剂 药物相关性副作用和不良反应 眼肌麻痹 米勒·费希尔综合征 重症肌无力 

分 类 号：R730.51[医药卫生—肿瘤] R77[医药卫生—临床医学]