Combination intravitreous melphalan and bevacizumb for cutaneous metastatic melanoma to the vitreous and retina.

Journal: American Journal Of Ophthalmology Case Reports
Published:
Abstract

Cutaneous melanoma metastatic to the vitreous/retina is rare but increasingly common. Due to the potential of recurrent disease with current treatment options and the propensity for these eyes to develop neovascularization, these eyes can pose a treatment challenge and novel management strategies are needed. This case series explores the use of combination, sequential intravitreous melphalan and bevacizumab. Two eyes of two patients with cutaneous melanoma metastatic to the vitreoretina were eye treated with combination intravitreous melphalan (10-30 mcg) and bevacizumab (1.25 mg) given sequentially during the same office visit, at monthly intervals. Both cases had control of disease at 7- and 12-months follow up. Furthermore, treatment reversed neovascular glaucoma and dramatically improved vision in the eye of one patient; and stabilized vision without the development of neovascularization in the eye of the other patient. There were no ocular adverse events noted in either eye. Combination, sequential intravitreous melphalan and bevacizumab is well-tolerated and an attractive approach for treating eyes with intraocular metastatic melanoma.

Authors
Jasmine Francis, Julia Canestraro, David Abramson, Christopher Barker, Alexander Shoushtari