irAE Uveitis — SCE Medical Oncology MCQ
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Correct answer: E — Urgent ophthalmology review using topical steroid and cycloplegic therapy
Confirmed checkpoint-associated anterior uveitis is treated under urgent ophthalmology supervision with topical corticosteroid and a cycloplegic. Urgent ophthalmology review with systemic steroid and no topical cycloplegic: systemic steroid is generally reserved for posterior, severe or refractory ocular inflammation. Urgent ophthalmology review with topical NSAID plus cycloplegic treatment: a topical NSAID is not the principal anti-inflammatory treatment for anterior uveitis. Urgent ophthalmology review with intravitreal anti-VEGF plus cycloplegic treatment: anti-VEGF treats retinal vascular disease rather than anterior chamber inflammation. Urgent ophthalmology review with topical steroid plus prophylactic antiviral therapy: antiviral treatment requires evidence of a herpetic cause rather than an immune toxicity.
Reference: ASCO clinical practice guideline for immune-checkpoint-inhibitor adverse events (Published 2018; current foundational guidance): https://pmc.ncbi.nlm.nih.gov/articles/PMC6481621/; West of Scotland Cancer Network immune-related adverse-events guideline (Version 4.0, March 2024; review due March 2027): https://rightdecisions.scot.nhs.uk/media/b11eeh40/woscan-immunotherapy-iraes-guideline-v40.pdf