The impact of intravitreal bevacizumab therapy on choroidal melanoma

Am J Ophthalmol. 2011 Feb;151(2):323-8.e2. doi: 10.1016/j.ajo.2010.08.040. Epub 2010 Dec 18.

Abstract

Purpose: To describe the clinical course and ancillary findings of 3 patients with choroidal melanoma who inadvertently received multiple intravitreal injections of bevacizumab for a presumed diagnosis of choroidal neovascular membrane.

Design: Observational case series.

Methods: Three patients with choroidal melanomas who received a series of monthly intravitreal injections of bevacizumab for presumed choroidal neovascularization were evaluated. Clinical, ultrasonographic, and angiographic findings are presented. Histopathologic features are correlated with clinical features in 2 patients who underwent enucleation.

Results: Lack of benefit in halting tumor progression was observed in all 3 cases. In 2 cases treated with enucleation, there was evidence of bevacizumab-induced gliotic/fibrotic retinal changes.

Conclusions: We present 3 cases of choroidal melanomas that showed progression while patients received multiple intravitreal injections of bevacizumab. The use of the drug led to the formation of a gliotic/fibrotic membrane that resulted in masking of the underlying tumor and consequently delayed the correct diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Choroid Neoplasms / diagnostic imaging
  • Choroid Neoplasms / drug therapy*
  • Choroid Neoplasms / pathology
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy
  • Diagnostic Errors
  • Eye Enucleation
  • Female
  • Fibrosis / pathology
  • Fluorescein Angiography
  • Gliosis / pathology
  • Humans
  • Intravitreal Injections
  • Melanoma / diagnostic imaging
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Middle Aged
  • Retina / pathology
  • Retreatment
  • Ultrasonography
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab