Ocular Metastatic Cutaneous Melanoma

Topic outline

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  Grand Rounds

  A patient with metastatic cutaneous melanoma to the eye was referred to BPEI glaucoma service for elevated IOP. Examination revealed 20/125 vision and IOP 31 mmHg on multiple glaucoma drops. Gonioscopy revealed a diffuse melanomatous membrane and pigment accumulation in the inferior angle. Dilated funduscopic exam revealed diffuse pigmentary retinal and subretinal deposits and infiltration of retinal vasculature. The patient had previously received systemic nivolumab and intravitreal melphalan. Serial PET scans were negative for extraocular metastatic disease. Given concern for the risk of extraocular seeding, incisional glaucoma surgery was deferred, and the patient underwent cyclophotocoagulation therapy. Significant IOP reduction was achieved.
  

  Presentation Date: 12/10/2020
  Issue Date: 07/16/2021
  

  • Presenter: Megan A. Rowlands, MD, MPH URL
  • Faculty Discussant: Sander R. Dubovy, MD URL
  • Faculty Discussant: David S. Greenfield, MD URL
  •     Faculty Discussant: J. William Harbour, MD
    
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