Ellipsoid Zone Loss as a Retinal Complication after Chimeric Antigen Receptor T-Cell Therapy: A Case Report
DOI:
https://doi.org/10.62856/djcro.v10.77Keywords:
adverse ocular effects, CAR-T cell therapy, ellipsoid zone, optical coherence tomography, reversible photoreceptor disruptionAbstract
We report a novel case of transient ellipsoid zone (EZ) disruption with subsequent spontaneous recovery following CD19-targeted CAR-T cell therapy for B-cell lymphoma. A 57-year-old male presented with gradual vision decline two months post-treatment. While clinical examination was unremarkable, optical coherence tomography (OCT) revealed bilateral EZ attenuation. Over five months of observation, serial OCT imaging documented complete EZ restoration, which correlated with improved visual acuity. This represents the first report of reversible EZ disruption linked to CAR-T therapy. The findings mirror phenomena seen in acute syphilitic posterior placoid chorioretinitis and following ocriplasmin injection. This case of reversible EZ loss suggests that previously reported visual complications in CAR-T patients, typically attributed to neurotoxicity, could have a retinal origin. We therefore recommend incorporating OCT imaging into the standard assessment of CAR-T patients experiencing visual symptoms to aid in the diagnosis and monitoring of this potential complication.
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