Supplemental Digital Content is Available in the Text.,The largest case series to date describing uveitis occurring secondary to systemic treatments for malignant melanoma.,Twenty-two cases are described.,Uveitis occurred after treatment with checkpoint, BRAF, and mitogen-activated protein kinase inhibitors.,To report the largest case series to date of uveitis occurring in association with immunomodulatory therapy for malignant melanoma.,A retrospective multicenter case review.,Twenty-two patients with uveitis occurring in association with either immunotherapy or targeted immune therapy for malignant melanoma were identified.,Of 22 patients, 11 had anterior uveitis in isolation.,The remainder showed a variety of clinical features including panuveitis, ocular hypotony, papillitis, cystoid macular edema, and melanoma-associated retinopathy.,Most patients responded well to treatment.,We report the largest case series to date of patients with uveitis secondary to drug treatment for malignant melanoma.,These cases are likely to increase in number in the future as newer immunomodulatory therapies for cancers are developed and the indications for these drugs increase.,A dilemma arises when patients respond well to these drugs but develop vision-threatening side effects.
Melanoma-associated retinopathy (MAR) is a paraneoplastic syndrome that involves the production of autoantibodies which can cross-react with retinal epitopes leading to visual symptoms.,Autoantibodies can target intracellular proteins, and only a few are directed against membrane proteins.,This discrepancy in autoantibody-protein target can translate into different immune responses (T-cell mediated vs B-cell mediated).,Historically, treatment of MAR has focused on surgical reduction or immunosuppressive medication, mainly glucocorticoids.,However, tumor resection is not relevant in metastatic melanoma in which MAR is mostly encountered.,Moreover, the use of glucocorticoids can reduce the efficacy of immunotherapy.,We report the first case to our knowledge with subjective resolution of visual symptoms and objective evidence of normalization of electroretinogram of MAR with undetectable autoantibodies after administration of programmed death-1 (PD-1) inhibitor (pembrolizumab) without the use of surgical reduction or systemic immunosuppression.,This case highlights the potential improvement and resolution of negative autoantibody MAR with the use of PD-1 inhibitors and emphasizes the importance of multidisciplinary approach and team discussion to avoid interventions that can decrease immunotherapy-mediated anti-tumor effect.