Pembrolizumab Associated Bilateral Optic Neuritis

PURPOSE: : Case report. RESULTS: A 52-year-old female on Pembrolizumab for vulvar squamous cell carcinoma developed bilateral optic neuritis due to an altered immune system secondary to pembrolizumab targeting her nervous system. CONCLUSION: Though brain metastasis and paraneoplastic optic neuropathy are feared complications in cancer patients with vision loss, drug induced bilateral optic neuropathy is a rare possibility and should be considered. As immune checkpoint inhibitors continue to grow in popularity and are approved for more uses, it is important for vigilant monitoring of immune-related adverse events (irAEs) as well as quick and effective management of these adverse reactions. Our patient did not respond to intravenous steroids and subsequent plasmapheresis helped good visual recovery.