A Case of Vogt-Koyanagi-Harada-like Syndrome Associated with Immunotherapy (Pembrolizumab)
10.3341/jkos.2023.64.12.1259
- Author:
Sejun PARK
1
;
Jong Beom PARK
;
Kiyoung KIM
Author Information
1. Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
- Publication Type:Case Report
- From:Journal of the Korean Ophthalmological Society
2023;64(12):1259-1262
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:To report a case of Vogt-Koyanagi-Harada-like syndrome that occurred during immunotherapy (pembrolizumab) in a patient with non-small-cell lung cancer (NSCLC).Case summary: A 64-year-old female visited our clinic complaining of decreased visual acuity in both eyes. The patient had NSCLC and had been prescribed immunotherapy (pembrolizumab) by the Department of Pulmonology. Fundus examination and optical coherence tomography revealed multiple intraretinal cysts and subretinal fluid in both eyes. After evaluation using fluorescein and indocyanine green angiography, Vogt-Koyanagi-Harada (VKH) disease was diagnosed in both eyes and oral prednisolone 40 mg/day was prescribed for 2 weeks. At an outpatient visit at that time, the symptoms had improved, and fundus examination and optical coherence tomography revealed decreases in the number of intraretinal cysts and the subretinal fluid level. Oral prednisolone was reduced to 20 mg/day for 2 weeks. At an outpatient visit at that time, the symptoms had further improved; no cysts or subretinal fluid were apparent on fundus examination or optical coherence tomography, and only a small amount of subretinal fluid was present near the macula of the right eye.
Conclusions:VKH disease may develop during immunotherapy (pembrolizumab) but can be rapidly diagnosed and treated with oral steroids.
