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67 year old man 67 year old man The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.   VA OD: Dcc20/200-2 PHNI Ncc20/800 VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.  VA OD: Dcc20/200-2 PHNI Ncc20/800 VA OS: Dcc20/63 PHNI NccJ7 IOP: TP: OD:15 OS:13 Last two sets of images are following plasma exchange, second set with 9 exchanges third set with another 5. Vision improved after 14 plasma exchanges to 20/160 OD and 20/32 OS

bdump_dastr_20211004_03.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 361 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_01.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 308 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_05.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 346 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_06.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 348 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_07.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 308 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_08.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 352 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_09.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 349 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_10.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 356 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_02.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 326 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_11.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 316 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_12.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 328 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_13.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 324 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_14.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 284 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_15.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 317 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_16.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 304 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_17.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 319 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_18.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 317 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_19.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 349 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_20.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 327 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_21.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 318 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_22.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 302 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_23.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 300 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_24.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 339 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_25.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 317 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_26.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 315 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_27.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 334 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_28.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 320 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_29.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 328 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_30.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 339 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_04.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 358 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_31.png
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 363 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_32.png
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 312 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_33.png
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 311 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211004_34.png
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 311 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211111_37_28229.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 303 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211111_38_28229.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 325 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211111_35.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 336 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211111_36.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 335 fois67 year old man
The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.  
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
00000
(0 votes)
bdump_dastr_20211227_41.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 323 fois67 year old man
Vision is better after 14 plasma exchanges, OD 20/160, OS 20/32
00000
(0 votes)
bdump_dastr_20211227_39.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 392 fois67 year old man
Vision is better after 14 plasma exchanges, OD 20/160, OS 20/32
00000
(0 votes)
bdump_dastr_20211227_42.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 336 fois67 year old man
Vision is better after 14 plasma exchanges, OD 20/160, OS 20/32
00000
(0 votes)
bdump_dastr_20211227_40.jpg
Bilateral Diffuse Melanocytic Proliferation (BDUMP)vu 362 fois67 year old man
Vision is better after 14 plasma exchanges, OD 20/160, OS 20/32
00000
(0 votes)
   
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67 year old man 67 year old man The patient started noticing dimming of the vision in November of 2020.  He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021.  The vision did not improve with the cataract surgery.  On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss.  The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss.  He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.    A retinal evaluation showed subretinal fluid and vision loss.   The peripheral vision and central vision were pretty good.  The vision did seem to get better off the nivolumab.  Then when the patient returned to Florida in September and now the vision is getting worse.  The patient did not have any treatments in either eye.  The patient is now off the oncology treatment.  He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month.  It was stopped because of a skin rash and reactions.   VA OD: Dcc20/200-2 PHNI Ncc20/800 VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.  VA OD: Dcc20/200-2 PHNI Ncc20/800 VA OS: Dcc20/63 PHNI NccJ7 IOP: TP: OD:15 OS:13 Last two sets of images are following plasma exchange, second set with 9 exchanges third set with another 5. Vision improved after 14 plasma exchanges to 20/160 OD and 20/32 OS