Post-Pembrolizumab Optic Neuritis in a 57-Year Old Female with non-small cell lung carcinoma

Author(s): Artur Manasyan, Nyree Khachikyan, Stephanie Gaytan and Nafiseh Hashemi

Pembrolizumab, also known as Keytruda, is a novel immunotherapeutic used for the treatment of certain cancers like non-small cell lung adenocarcinoma, melanoma, among other types. It is a checkpoint inhibitor that targets the PD-1/PD-L1 interaction and suppresses immune resistance of cancerous cells. We present a case of 57-year-old female who was treated with pembrolizumab for non-small cell lung adenocarcinoma and subsequently developed bilateral optic neuritis. The patient developed worsening vision and a constricted field of vision as a result. Pembrolizumab therapy was stopped, followed by immediate administration of corticosteroid therapy. As a result, the patient’s vision experienced moderate improvement without full remission due to the consequential post-swelling optic atrophy. Although pembrolizumab is a very effective and FDA approved treatment, reports of such rare cases are important in helping guide treatment plans of future patients.