Development of Vogt–Koyanagi–Harada Disease-like Uveitis during Treatment by Anti-programmed Death Ligand-1 Antibody for Non-small Cell Lung Cancer: A Case Report

ABSTRACT

Background

Several types of immune checkpoint inhibitors (ICIs) have been reported to occasionally cause Vogt-Koyanagi-Harada disease (VKHD)-like uveitis. Among the ICIs, the anti-programmed death ligand-1 (PD-L1) antibody is reported to cause fewer immune-related adverse events (irAEs). We report a case of VKHD-like uveitis that developed after anti-PD-L1 antibody treatment for non-small cell lung cancer (NSCLC).

Case presentation

A 76-year-old woman suffered from an acute visual reduction in both eyes. She had been treated with atezolizumab, an anti-PD-L1 antibody, for NSCLC for 17 months. Ophthalmologic examinations led to a diagnosis of severe VKHD-like uveitis, and one of the irAEs was suspected. Discontinuation of atezolizumab and systemic steroid therapy led to the resolution of the findings within two months.

Conclusions

This is the first report of VKHD-like uveitis that developed during the treatment by anti-PD-L1 antibody. Our case indicates that VKHD-like uveitis may be induced after a long-time use of anti-PD-L1 antibody.

KEYWORDS:

• Anti-PD-L1
• Vogt-Koyanagi-Harada disease
• immune-related adverse events
• ICIs

Acknowledgments

We thank Professor Emeritus Duco Hamasaki (Bascom Palmer Eye Institute) for discussions and editing the manuscript.

We also thank Dr. Akane Ishida (Center Hospital of the National Center for Global Health and Medicine) for her advice regarding our report.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Data availability statement

Data available on request from the authors.

Additional information

Funding

This work was supported by Takayanagi Retina Research Award (RT).