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.
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References
Rosenberg C, Finger PT (2008) Cutaneous malignant melanoma metastatic to the eye, lids, and orbit. Surv Ophthalmol 53:187–202
Dean E, Lorigan P (2012) Advances in the management of melanoma: targeted therapy, immunotherapy and future directions. Expert Rev Anticancer Ther 12:1437–1448
Miller AJ, Mihm MC Jr (2006) Melanoma. N Engl J Med 355:51–65
Kurschat P, Mauch C (2000) Mechanisms of metastasis. Clin Exp Dermatol 25:482–489
Heindl LM, Cursiefen C (2010) Pterygium. Etiology, clinical aspects and novel adjuvant therapies. Der Ophthalmol : Z Dtsch Ophthalmol Ges 107:517–520, 522–514
Yam JC, Kwok AK (2013) Ultraviolet light and ocular diseases. Int Ophthalmol May 31 [Epub ahead of print]
Chalam KV, Khetpal V, Rusovici R, Balaiya S (2011) A review: role of ultraviolet radiation in age-related macular degeneration. Eye Contact Lens 37:225–232
Aronow ME, Adamus G, Abu-Asab M, Wang Y, Chan CC, Zakov ZN, Singh AD (2012) Paraneoplastic vitelliform retinopathy: clinicopathologic correlation and review of the literature. Surv Ophthalmol 57:558–564
Sotodeh M, Paridaens D, Keunen J, van Schooneveld M, Adamus G, Baarsma S (2005) Paraneoplastic vitelliform retinopathy associated with cutaneous or uveal melanoma and metastases. Klin Monatsbl Augenheilkd 222:910–914
Al-Dahmash SA, Shields CL, Bianciotto CG, Witkin AJ, Witkin SR, Shields JA (2012) Acute exudative paraneoplastic polymorphous vitelliform maculopathy in five cases. Ophthalmic Surg Lasers Imaging : Off J Int Soc Imaging Eye 43:366–373
Chan CK, Gass JD, Lin SG (2003) Acute exudative polymorphous vitelliform maculopathy syndrome. Retina 23:453–462
Grunwald L, Kligman BE, Shields CL (2011) Acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with carcinoma, not melanoma. Arch Ophthalmol 129:1104–1106
Di Tondo U, Balestrazzi E, Santeusanio G, Pintucci S, Spadea L (1986) Steroids and neuroendocrine hormones detected by the immunoperoxidase technique from malignant melanomas and nevi of the choroid and conjunctiva. Ophthalmologica 192:34–38
Orth DN (1973) Establishment of human malignant melanoma clonal cell lines that secrete ectopic adrenocorticotropin. Nat New Biol 242:26–28
Carey RM, Orth DN, Hartmann WH (1973) Malignant melanoma with ectopic production of adrenocorticotropic hormone. Palliative treatment with inhibitors of adrenal steroid biosynthesis. J Clin Endocrinol Metab 36:482–487
Gupta A, Dhawahir-Scala F, Smith A, Young L, Charles S (2007) Radiation retinopathy: case report and review. BMC Ophthalmol 7:6
Modi D, Dubovy SR (2013) Non-leaking cystoid maculopathy secondary to systemic paclitaxel. Ophthalmic Surg Lasers Imaging 44:183–186
Kahn HA, Leibowitz HM, Ganley JP, Kini MM, Colton T, Nickerson RS, Dawber TR (1977) The Framingham Eye study. I. Outline and major prevalence findings. Am J Epidemiol 106:17–32
Wong TY, Hyman L (2008) Population-based studies in ophthalmology. Am J Ophthalmol 146:656–663
Robinson B, Acorn CJ, Millar CC, Lyle WM (1997) The prevalence of selected ocular diseases and conditions. Optom Vis Sci 74:79–91
Horle S, Gruner F, Kroll P (2002) Epidemiology of diabetes-induced blindness—a review. Klin Monatsbl Augenheilkd 219:777–784
Thylefors B, Negrel AD, Pararajasegaram R (1992) Epidemiologic aspects of global blindness prevention. Curr Opin Ophthalmol 3:824–834
Saxena S, Sinha N, Sharma S (2011) Three-dimensional imaging by spectral domain optical coherence tomography in central serous chorioretinopathy with fibrin. J Ocul Biol Dis Inform 4:149–153
Symeonidis C, Kaprinis K, Manthos K, Androudi S, Anastassilakis K, Dimitrakos SA (2011) Central serous chorioretinopathy with subretinal deposition of fibrin-like material and its prompt response to ranibizumab injections. Case Rep Ophthalmol 2:59–64
Carvalho-Recchia CA, Yannuzzi LA, Negrao S, Spaide RF, Freund KB, Rodriguez-Coleman H, Lenharo M, Iida T (2002) Corticosteroids and central serous chorioretinopathy. Ophthalmology 109:1834–1837
Javaheri M, Khurana RN, Bhatti RA, Lim JI (2008) Optical coherence tomography findings in paraneoplastic pseudovitelliform lesions in melanoma-associated retinopathy. Clin Ophthalmol 2:461–463
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.).
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No author has any financial/conflicting interests to disclose.
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Grajewski, R.S., Schuler-Thurner, B., Mauch, C. et al. Ocular diseases in metastatic cutaneous melanoma: review of 108 consecutive patients in two German tertiary centers. Graefes Arch Clin Exp Ophthalmol 252, 679–685 (2014). https://doi.org/10.1007/s00417-013-2563-5
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DOI: https://doi.org/10.1007/s00417-013-2563-5