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Ocular diseases in metastatic cutaneous melanoma: review of 108 consecutive patients in two German tertiary centers

  • Rafael S. Grajewski
  • Beatrice Schuler-Thurner
  • Cornelia Mauch
  • Nicole Kreuzberg
  • Konrad R. Koch
  • Antonio Bergua
  • Claus Cursiefen
  • Ludwig M. Heindl
Oncology

Abstract

Purpose

To analyze the incidence and spectrum of ocular disease in patients with metastatic cutaneous melanoma.

Methods

One hundred and eight consecutive patients with metastatic cutaneous melanoma were screened for ocular diseases using standardized eye examination, including measurement of visual acuity and intraocular pressure, slit-lamp examination, funduscopy in mydriasis, and spectral-domain optical coherence tomography (SDOCT) of the retina. Selected cases with atypical findings underwent electrophysiological studies. One patient was examined for hypercortisolism by a dexamethasone suppression test.

Results

Ocular diseases were found in 65 out of 108 patients (60 %) with metastatic cutaneous melanoma, significantly more often in older patients (p = 0.004). Cataract was present in 27 patients (25 %), pseudophakia in 22 patients (20 %), macular disease in 29 patients (28 %), diabetic retinopathy in ten patients (9 %), hypertensive retinal disease in 14 patients (13 %), retinal venous and arterial occlusive disease in three patients (3 %), optic neuropathy in four patients (4 %), and uveitis in one patient (1 %). Eight patients (8 %) had choroidal or iridal nevi, one patient (1 %) choroidal hemangioma, and one patient (1 %) choroidal metastasis. No patient had periocular neoplastic lesions. Paraneoplastic retinopathy manifesting as acute exudative polymorphous vitelliform maculopathy (AEPVM)-like disease was diagnosed in two patients (2 %) with multifocal central serous chorioretinopathy and development of vitelliform or fibrin-like subretinal deposits in one patient.

Conclusions

Patients with metastatic cutaneous melanoma reveal ocular diseases with a spectrum similar to the normal population of this age range. Very rarely, uveal metastasis as well as paraneoplastic retinopathy can occur.

Keywords

Oncology Cutaneous melanoma Ocular diseases Paraneoplastic retinopathy 

Notes

Acknowledgments

We thank Professor Christof Schöfl, Division of Endocrinology and Diabetes, Department of Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany, for the excellent performance and analysis of a dexamethasone suppression test in one patient.

Financial support

“Forschung für das Sehen e.V.”, Cologne, DFG Gr 2647/4-1 (to R.S.G.), DFG Cu 47/4-1 and Cu 47/6-1 (to C.C.), DFG HE 6743/2-1 and Gerok programme by the University of Cologne (to L.M.H.).

Conflict of interest

No author has any financial/conflicting interests to disclose.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Rafael S. Grajewski
    • 1
  • Beatrice Schuler-Thurner
    • 2
  • Cornelia Mauch
    • 3
  • Nicole Kreuzberg
    • 3
  • Konrad R. Koch
    • 1
  • Antonio Bergua
    • 4
  • Claus Cursiefen
    • 1
  • Ludwig M. Heindl
    • 1
  1. 1.Department of OphthalmologyUniversity of CologneCologneGermany
  2. 2.Department of DermatologyUniversity of Erlangen-NurembergErlangenGermany
  3. 3.Department of Dermatology and Venerology, Skin Cancer CenterUniversity of CologneCologneGermany
  4. 4.Department of OphthalmologyUniversity of Erlangen-NurembergErlangenGermany

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