Arevalo J Fernando, Espinoza Juan V
The Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; The Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
J Ophthalmic Vis Res. 2012 Oct;7(4):332-40.
To report the effectiveness of indocyanine green mediated photothrombosis (IMP) combined with high dose (4 mg/0.16 ml) intravitreal bevacizumab (IVB) as adjunctive therapy for management of isolated choroidal metastasis from breast cancer.
This retrospective interventional case report includes three eyes of two patients with choroidal metastasis from breast cancer. Both patients were submitted to one session of IMP combined with high dose IVB as adjuvant local therapy to systemic chemotherapy. Main outcome measures were tumor response, and fluorescein angiography (FA), optical coherence tomography (OCT), and visual acuity (VA) results.
The first patient was a 47-year-old woman who had undergone radical mastectomy, chemotherapy and radiotherapy 7 years earlier and the second patient was a 70-year-old woman managed with chemotherapy and radiotherapy 16 years before presentation. There was no evidence of systemic metastasis in either case and both suffered from gradually blurred vision. The first patient presented with a unilateral choroidal lesion whereas the second case had bilateral unifocal choroidal lesions which was symptomatic in only one eye. Clinical examination, ultrasonography, FA, and OCT revealed accompanying exudative retinal detachment in all three eyes. OCT 3 to 5 weeks after combined therapy demonstrated complete resolution of subretinal fluid and improved VA in two eyes.
Combined IMP and high-dose IVB seems to be an effective adjunctive treatment to systemic chemotherapy for management of isolated choroidal metastasis from breast cancer.
报告吲哚菁绿介导的光血栓形成（IMP）联合高剂量（4mg/0.16ml）玻璃体内注射贝伐单抗（IVB）作为辅助治疗乳腺癌孤立性脉络膜转移的有效性。
本回顾性介入病例报告包括2例乳腺癌脉络膜转移患者的3只眼。两名患者均接受了一次IMP联合高剂量IVB治疗，作为全身化疗的辅助局部治疗。主要观察指标为肿瘤反应、荧光素血管造影（FA）、光学相干断层扫描（OCT）和视力（VA）结果。
首例患者为47岁女性，7年前接受了根治性乳房切除术、化疗和放疗；第二例患者为70岁女性，就诊前16年接受了化疗和放疗。两例均无全身转移证据，均有视力逐渐模糊症状。首例患者表现为单侧脉络膜病变，而第二例为双侧单灶脉络膜病变，仅一只眼有症状。临床检查、超声检查、FA和OCT显示所有三只眼均伴有渗出性视网膜脱离。联合治疗3至5周后的OCT显示，两只眼的视网膜下液完全消退，视力改善。
IMP联合高剂量IVB似乎是全身化疗治疗乳腺癌孤立性脉络膜转移的有效辅助治疗方法。
