Intravitreal Aflibercept as the Adjuvant Therapy of Presumed Primary Uveal Melanoma - Case report
Purpose
To report a case of presumed primary uveal melanoma.
Methods
Interventional case report.
Results
This is a 74-year-old female who complained of blurred vision in the right eye for 6 months. Her BCVA was 0.1. Fundus autofluorescence showed hypo-autofluorescent appearance and OCT demonstrated subretinal fluid and marked retinal edema. FA showed hypofluorescent in the early phase and heterogeneously hyperfluorescent in the late phase. B-scan showed a dome-shaped lesion with a medium-to-high homogeneous reflectivity and a high height to base ratio. A choroidal tumor was suspected, so she was referred to the oncologist and systemic malignancy had ruled out. MRI showed a T1 moderately high signal and T2 moderately low signal mass lesion. Enhancement with gadolinium contrast was noted. Choroidal melanoma was suspected. Transpupillary thermotherapy and 3 weekly 4mg intravitreal bevacizumab were performed. Only slightly less retinal edema was noted. The subretinal fluid persisted. Confluent transpupillary thermotherapy and 2 weekly intravitreal 4 mg aflibercept were performed. Retinal edema and subretinal fluid subsided markedly. Her vision improved to 0.8. The macula had remained fluid-free for 3 months; however, the mass persisted.
Conclusion
Intravitreal aflibercept could be considered as the adjuvant therapy of presumed primary uveal melanoma. More cases and longer follow-up are mandatory.
Conflict of interest
No
Author 1
Last name
LIN
Initials of first name(s)
CJ
Department
Department of Ophthalmology, China Medical University Hospital; Department of Optometry, Asia Uni
City
Taichung
Country
Taiwan
Author 2
Last name
Huang
Initials of first name(s)
YT
City
Taichung
Country
Taiwan
Author 3
Last name
Hsia
Initials of first name(s)
NY
City
Taichung
Country
Taiwan
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