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Corticosteroid Treatment for Melanoma-Associated Retinopathy

2004; American Medical Association; Volume: 140; Issue: 10 Linguagem: Inglês

10.1001/archderm.140.10.1258

1538-3652

C. Jacobzone, C. Cochard-Marianowski, I. Kupfer, S. Benchekroun Bettembourg, Yves Dordain, L. Misery, Béatrice Cochener, B. Sassolas,

Ocular Oncology and Treatments

Background: Visual disturbance in the course of melanoma is rare.Specific localized metastases and drug toxic effects are frequently the cause.Recognition of a retinopathy raises several questions when the diagnosis of melanoma-associated retinopathy (MAR) can be confirmed.Descriptions of such patients in dermatologic literature are rare and deserve attention because therapeutic decisions are mandatory.Observations: A 70-year-old woman had a first melanoma in 1985 and a second primary melanoma in 1994.Axillary lymph node involvement occurred in November 2000, leading to surgery and chemotherapy.In December 2001, she had sudden bilateral visual loss, with shimmering blobs of color and flickering photopsias.Computed tomography and cerebral magnetic resonance imaging ruled out localized tumor on the eyes or optic nerves or evolution of disease.Ophthalmologic ex-amination revealed a bilateral posterior uveitis, with hyalitis and progressive destruction of retinal pigment.The electrophysiologic data confirmed the diagnosis of MAR.Symptoms improved after systemic corticosteroid therapy, with no relapse after tapering doses despite worsening of melanoma.