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....

Descripción completa

Detalles Bibliográficos
Autores principales: Obata, Shumpei, Saishin, Yoshitsugu, Teramura, Kazuya, Ohji, Masahito
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