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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
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Immunotherapy-Resistant Vitreoretinal Metastatic Melanoma.
Arthi Venkat1, Elaine M Binkley1, Sunil Srivastava1
1Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Ocular Oncology and Pathology
|April 2, 2021
Summary
Metastatic melanoma patients receiving immunotherapy can develop vitreoretinal metastases, even with good systemic response. This suggests immunotherapies may extend lifespan, allowing ocular metastasis to emerge.
Area of Science:
- Ophthalmology
- Oncology
- Immunotherapy
Background:
- Metastatic melanoma treatment has advanced with systemic immunotherapy.
- Ocular metastases are a rare but serious complication of metastatic melanoma.
Observation:
- Two patients with metastatic melanoma treated with ipilimumab and nivolumab developed vitreoretinal metastases.
- Despite complete systemic remission, one patient required enucleation, while the other received radiation therapy.
Findings:
- Vitreoretinal metastasis occurred despite favorable systemic response to immunotherapy.
- Diagnostic pars plana vitrectomy confirmed metastatic melanoma in both cases.
Implications:
- Immunotherapy's efficacy in extending lifespan may contribute to the development of vitreoretinal metastases.
- Ophthalmologists should consider ocular metastasis in patients with metastatic melanoma on immunotherapy presenting with ocular symptoms.
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