Vogt-Koyanagi-Harada-like uveitis with severe hyalitis during treatment by anti-programmed death 1 antibody for lung cancer: a case report.

BACKGROUND

Vogt-Koyanagi-Harada-like uveitis that presents with severe hyalitis has rarely been reported during anti-programmed death 1 therapy.

CASE PRESENTATION: A 70-year-old Chinese man presented with bilateral visual disturbances and vomiting after four cycles of serplulimab, an anti-programmed death 1 antibody, for metastatic lung carcinoma. His best corrected visual acuity was measured at 0.04 in the right eye and 0.02 in the left eye. A slit-lamp examination indicated severe hyalitis, while ocular ultrasound revealed focal serous retinal detachment. Magnetic resonance imaging demonstrated choroidal thickening and cerebrospinal fluid analysis indicated a mild lymphocytic elevation. Retinal fluorescein angiography exhibited focal pinpoint leakage and delayed hyperfluorescence at the optic disc. A diagnosis of Vogt-Koyanagi-Harada-like uveitis secondary to anti-programmed death 1 therapy was established. Following the discontinuation of anti-programmed death 1 treatment and 1-month course of oral prednisone at a dosage of 40 mg per day, the patient's best corrected visual acuity improved to 0.6 in the right eye and 0.4 in the left eye.

CONCLUSION

Corticosteroid treatment has proven effective for Vogt-Koyanagi-Harada-like uveitis. Currently, the optimal mode and dosage of corticosteroid therapy have not been clearly defined. Gathering more real-world cases of Vogt-Koyanagi-Harada-like uveitis associated with anti-programmed death 1 antibodies would be beneficial in developing therapeutic guidelines.