Bilateral drug (ipilimumab)-induced vitritis, choroiditis, and serous retinal detachments suggestive of vogt-koyanagi-harada syndrome

Ryan K. Wong, Jimmy K. Lee, John J. Huang

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: To report a case of bilateral drug (ipilimumab)-induced vitritis, choroiditis, and serous retinal detachments suggestive of Vogt-Koyanagi-Harada syndrome. Methods: This is a single case report. Results: A 43-year-old woman with metastatic melanoma reported a 1-day history of blurry vision after starting a phase 1 clinical trial of ipilimumab, a cytotoxic T lymphocyte- associated antigen 4 blocker, 2 weeks before presentation. Fundus examination of both eyes showed bilateral serous detachments with associated vitritis and choroiditis. Optical coherence tomography confirmed the presence of serous detachments, and fluorescein angiography demonstrated multiple areas of pinpoint leakage at the level of the retinal pigment epithelium. Treatment with high-dose corticosteroids led to a rapid improvement in vision and resolution of her serous detachments. Ten weeks after initial presentation, the patient developed vitiligo and poliosis. Conclusion: Vogt-Koyanagi-Harada syndrome is a bilateral granulomatous panuveitis associated with dermatologic, neurologic, and audiologic manifestations of yet an unclear pathogenesis. To our knowledge, we report the first case of ipilimumab treatment resulting in the acute presentation of bilateral vitritis, choroiditis, and serous detachments suggestive of Vogt-Koyanagi-Harada syndrome, which has particular significance because it may corroborate previous research attempting to elucidate the underlying mechanism of the disease.

Original languageEnglish (US)
Pages (from-to)423-426
Number of pages4
JournalRetinal Cases and Brief Reports
Volume6
Issue number4
DOIs
StatePublished - Sep 2012
Externally publishedYes

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Choroiditis
Uveomeningoencephalitic Syndrome
Retinal Detachment
Panuveitis
CTLA-4 Antigen
Pharmaceutical Preparations
Vitiligo
Clinical Trials, Phase I
Retinal Pigment Epithelium
Fluorescein Angiography
Optical Coherence Tomography
Neurologic Manifestations
Melanoma
Adrenal Cortex Hormones
Therapeutics
Research
ipilimumab

Keywords

  • Cytotoxic T lymphocyte-associated antigen 4 blocker
  • Ipilimumab
  • Melanoma
  • Uveitis
  • Vogt-Koyanagi-Harada syndrome

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Bilateral drug (ipilimumab)-induced vitritis, choroiditis, and serous retinal detachments suggestive of vogt-koyanagi-harada syndrome. / Wong, Ryan K.; Lee, Jimmy K.; Huang, John J.

In: Retinal Cases and Brief Reports, Vol. 6, No. 4, 09.2012, p. 423-426.

Research output: Contribution to journalArticle

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