Cargando…
Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma
Nivolumab is an anti-programmed cell death protein 1 monoclonal antibody that is used to treat metastatic cutaneous malignant melanoma. Although bilateral uveitis has been reported as a side effect of nivolumab administration, there are few reports of Vogt-Koyanagi-Harada disease (VKH)-like uveitis....
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489058/ https://www.ncbi.nlm.nih.gov/pubmed/31097947 http://dx.doi.org/10.1159/000496682 |
_version_ | 1783414751736365056 |
---|---|
author | Obata, Shumpei Saishin, Yoshitsugu Teramura, Kazuya Ohji, Masahito |
author_facet | Obata, Shumpei Saishin, Yoshitsugu Teramura, Kazuya Ohji, Masahito |
author_sort | Obata, Shumpei |
collection | PubMed |
description | Nivolumab is an anti-programmed cell death protein 1 monoclonal antibody that is used to treat metastatic cutaneous malignant melanoma. Although bilateral uveitis has been reported as a side effect of nivolumab administration, there are few reports of Vogt-Koyanagi-Harada disease (VKH)-like uveitis. We report such a case. A 63-year-old woman with metastatic cutaneous malignant melanoma experienced visual loss in both eyes 10 days after her second nivolumab injection. Her decimal best-corrected visual acuity (BCVA) was 0.7 in the right eye and 0.4 in the left eye. Examination revealed bilateral granulomatous keratic precipitates and posterior synechiae in the left eye. Optical coherence tomography showed multiple sites of serous retinal detachment (SRD) in the left eye and wavy retinal pigment epithelium in both eyes. Fluorescein angiography revealed multiple pinpoint-sized areas of leakage in both eyes and active leakage from the disc in her right eye. Indocyanine green angiography (IA) showed choroidal hyperfluorescence due to choroidal vascular leakage, with hypofluorescent dark spots during the late phase. These findings supported a diagnosis of VKH-like uveitis following nivolumab injections. Nivolumab was discontinued because of headache. Anterior chamber inflammation disappeared 3 weeks after starting topical corticosteroid treatment, and the SRD disappeared within 3 months. Her decimal BCVA recovered to 1.0 in the right eye and to 0.9 in the left eye. Also, the fluorescein angiography and IA findings had improved by 4 months. We concluded that careful follow-up is required after nivolumab treatment because VKH-like panuveitis might develop. |
format | Online Article Text |
id | pubmed-6489058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-64890582019-05-16 Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma Obata, Shumpei Saishin, Yoshitsugu Teramura, Kazuya Ohji, Masahito Case Rep Ophthalmol Case Report Nivolumab is an anti-programmed cell death protein 1 monoclonal antibody that is used to treat metastatic cutaneous malignant melanoma. Although bilateral uveitis has been reported as a side effect of nivolumab administration, there are few reports of Vogt-Koyanagi-Harada disease (VKH)-like uveitis. We report such a case. A 63-year-old woman with metastatic cutaneous malignant melanoma experienced visual loss in both eyes 10 days after her second nivolumab injection. Her decimal best-corrected visual acuity (BCVA) was 0.7 in the right eye and 0.4 in the left eye. Examination revealed bilateral granulomatous keratic precipitates and posterior synechiae in the left eye. Optical coherence tomography showed multiple sites of serous retinal detachment (SRD) in the left eye and wavy retinal pigment epithelium in both eyes. Fluorescein angiography revealed multiple pinpoint-sized areas of leakage in both eyes and active leakage from the disc in her right eye. Indocyanine green angiography (IA) showed choroidal hyperfluorescence due to choroidal vascular leakage, with hypofluorescent dark spots during the late phase. These findings supported a diagnosis of VKH-like uveitis following nivolumab injections. Nivolumab was discontinued because of headache. Anterior chamber inflammation disappeared 3 weeks after starting topical corticosteroid treatment, and the SRD disappeared within 3 months. Her decimal BCVA recovered to 1.0 in the right eye and to 0.9 in the left eye. Also, the fluorescein angiography and IA findings had improved by 4 months. We concluded that careful follow-up is required after nivolumab treatment because VKH-like panuveitis might develop. S. Karger AG 2019-02-08 /pmc/articles/PMC6489058/ /pubmed/31097947 http://dx.doi.org/10.1159/000496682 Text en Copyright © 2019 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Case Report Obata, Shumpei Saishin, Yoshitsugu Teramura, Kazuya Ohji, Masahito Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title | Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title_full | Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title_fullStr | Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title_full_unstemmed | Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title_short | Vogt-Koyanagi-Harada Disease-Like Uveitis during Nivolumab (Anti-PD-1 Antibody) Treatment for Metastatic Cutaneous Malignant Melanoma |
title_sort | vogt-koyanagi-harada disease-like uveitis during nivolumab (anti-pd-1 antibody) treatment for metastatic cutaneous malignant melanoma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489058/ https://www.ncbi.nlm.nih.gov/pubmed/31097947 http://dx.doi.org/10.1159/000496682 |
work_keys_str_mv | AT obatashumpei vogtkoyanagiharadadiseaselikeuveitisduringnivolumabantipd1antibodytreatmentformetastaticcutaneousmalignantmelanoma AT saishinyoshitsugu vogtkoyanagiharadadiseaselikeuveitisduringnivolumabantipd1antibodytreatmentformetastaticcutaneousmalignantmelanoma AT teramurakazuya vogtkoyanagiharadadiseaselikeuveitisduringnivolumabantipd1antibodytreatmentformetastaticcutaneousmalignantmelanoma AT ohjimasahito vogtkoyanagiharadadiseaselikeuveitisduringnivolumabantipd1antibodytreatmentformetastaticcutaneousmalignantmelanoma |