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CASE REPORT article
Front. Oncol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1492011
Laser speckle flowgraphy in a patient with uveitis due to immune-related adverse events by immune checkpoint inhibitors
Provisionally accepted- Hokkaido University, Sapporo, Japan
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Purpose: There remains unknown whether choroidal circulation could be altered at the onset of immune checkpoint inhibitor (ICI)-uveitis compared to that before ICI treatment.We herein report a patient with Vogt-Koyanagi-Harada (VKH) disease-like uveitis in unaffected eye as an immune-related adverse effect (irAE) due to ICIs for metastatic choroidal melanoma who had received enucleation. Moreover, choroidal circulation and choroidal thickness were measured before and after treatment.A 58-year-old man had a medical history of enucleation in his left eye due to choroidal melanoma 6 years ago. Metastatic lesions in the gastrointestinal tracts and lung were found, and then he received ICIs 3 times. About 1 month later, he suffered from blurred vision and metamorphopsia in his right eye. Choroidal circulation was evaluated by mean blur rate (MBR), a relative value showing choroidal blood velocity on laser speckle flowgraphy. Central choroidal thickness (CCT) was measured on optical coherence tomography.Results: Since ophthalmic findings revealed VKH-like uveitis, oral prednisolone of 30 mg was given for 2 weeks, which were then tapered. MBR was reduced and CCT increased at the onset of ICI-uveitis compared to its baseline and resolution after corticosteroid treatment.Conclusions: Choroidal circulation was disrupted, possibly due to ICI-induced autoinflammatory reaction to the choroid, which was managed by corticosteroid treatment. The combination of MBR and CCT could be a useful biomarker to manage the patients with VKH-like uveitis by ICIs.
Keywords: Immune check inhibitor (ICI), Immune related adverse effects (irAEs), Uveitis, Laser speckle flowgraphy, Corticosteriod
Received: 06 Sep 2024; Accepted: 21 Apr 2025.
Copyright: © 2025 Kase, Yamashita, Takeuchi and Ishida. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Satoru Kase, Hokkaido University, Sapporo, Japan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.