Sia David I T, Thaung Caroline, O'Hanlon-Brown Ciara, Cohen Victoria M L, Sagoo Mandeep S
Moorfields Eye Hospital.
UCL Institute of Ophthalmology, University College London.
Melanoma Res. 2018 Aug;28(4):359-362. doi: 10.1097/CMR.0000000000000443.
This report concerns a 49-year-old female with cutaneous malignant melanoma and systemic metastases. These resolved following combination immunotherapy with ipilimumab and nivolumab. She subsequently experienced unilateral floaters, an increase in iris pigmentation and pigmentary glaucoma. The eye progressively lost vision and became painful due to iris neovascularization. The clinical diagnosis was of cutaneous melanoma metastatic to the vitreous, ciliary body and iris. Enucleation was performed for symptom control, with histopathology confirming the clinical diagnosis. The immune privilege of the eye may preclude ocular metastasis control with immunotherapy. Ocular symptoms in such patients merit referral to an ophthalmologist.
本报告涉及一名49岁患有皮肤恶性黑色素瘤并伴有全身转移的女性。在接受伊匹单抗和纳武单抗联合免疫治疗后，这些转移灶得到缓解。随后，她出现了单侧飞蚊症、虹膜色素沉着增加和色素性青光眼。由于虹膜新生血管形成，眼睛逐渐丧失视力并变得疼痛。临床诊断为皮肤黑色素瘤转移至玻璃体、睫状体和虹膜。为控制症状进行了眼球摘除术，组织病理学证实了临床诊断。眼睛的免疫赦免可能会妨碍通过免疫疗法控制眼部转移。此类患者的眼部症状值得转诊给眼科医生。
