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Vol.60 No.5 contents | Japanese/English |
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- Case Report -
A Case of Non-small-cell Lung Cancer with Acute Optic Neuritis Observed After Pembrolizumab Treatment
Misaki Ogawa1, Yoko Tateishi1, Hirotaka Suzuki2, Yuki Tomita1, Mikinori Miyazaki1, Masaaki Sano31Department of Pulmonary Medicine, Nagoya Memorial Hospital, Japan, 2Department of Pulmonary Medicine, Nagoya Daini Red Cross Hospital, Japan, 3Department of Thoracic Surgery, Nagoya Memorial Hospital, Japan
Background. There are few reports regarding optic neuritis as an immune-related adverse event after pembrolizumab treatment. Case Report. A 71-year-old man received pembrolizumab for postoperatively recurrent squamous cell carcinoma of the lung. Although the tumor shrank, he noticed a decline in his right eye vision after nine courses of pembrolizumab treatment. A clinical examination revealed reduced visual acuity, relative afferent pupillary defects, reduced critical fusion frequency, and a narrowed field of vision. Optical coherence tomography also revealed a swollen optic disc. Therefore, we diagnosed the patient with acute optic neuritis. Two weeks later, the patient presented with similar findings in the left eye. We discontinued the pembrolizumab treatment based on suspicion that acute optic neuritis had occurred as an immune-related adverse event. An ophthalmologist treated the patient using ocular injection of corticosteroids, which resulted in improvements in the critical fusion frequency and observable corrected vision. Summary. Acute optic neuritis is a rarely reported immune-related adverse event after pembrolizumab treatment. Nevertheless, it is extremely important to consider acute optic neuritis when a patient develops loss of vision, visual field disorder, and eye pain in this setting. The early diagnosis and treatment of these cases will help prevent the development of blindness among patients who are receiving pembrolizumab for cancer.
key words: Acute optic neuritis, Pembrolizumab, Non-small-cell lung cancer, Immune-related adverse event, Immune checkpoint inhibitor
Received: February 6, 2020
Accepted: May 27, 2020
JJLC 60 (5): 385-389, 2020
