Fatehi Nima, McCannel Tara A, Giaconi JoAnn, Caprioli Joseph, Law Simon K, Nouri-Mahdavi Kouros
Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Ocul Oncol Pathol. 2019 Jan;5(1):20-27. doi: 10.1159/000488056. Epub 2018 May 2.
We report patient safety and intraocular pressure (IOP) control after placement of a glaucoma drainage device (GDD) in eyes with a history of treated malignant uveal melanoma.
A retrospective review of the records of patients with uveal melanoma was performed. Outcomes were local tumor recurrence, rate of metastases, and to-nometric success, based on survival curves, defined as IOP < 21 mm Hg.
Eleven eyes with choroidal melanoma, 4 with iris melanoma, and 1 with ciliary body melanoma were followed for a median (interquartile range) of 2.1 (1.1-3.2) years. Two subjects developed liver metastases; one had monosomy 3 and tumor gene expression profile class 2. The other case with ciliary body melanoma was negative for monosomy 3. There were no cases of local treatment failure. Mean preoperative IOP decreased from 30.5 ± 7.7 to 15.9 ± 8.1 mm Hg at 1 year after surgery (1-year success rate 80%).
Our case series with a median follow-up of 2 years shows that placing a GDD in patients with treated uveal melanoma does not expose patients to greater risk of local or extraocular recurrence. A larger series and longer follow-up time are required to fully evaluate the safety of GDDs in this clinical scenario.
我们报告了在有治疗过的恶性葡萄膜黑色素瘤病史的眼中植入青光眼引流装置（GDD）后的患者安全性和眼压（IOP）控制情况。
对葡萄膜黑色素瘤患者的记录进行回顾性分析。基于生存曲线，观察指标为局部肿瘤复发、转移率和眼压测量成功情况，眼压测量成功定义为眼压<21 mmHg。
11只脉络膜黑色素瘤眼、4只虹膜黑色素瘤眼和1只睫状体黑色素瘤眼接受了中位（四分位间距）2.1（1.1 - 3.2）年的随访。两名受试者发生肝转移；其中一名有3号染色体单体和肿瘤基因表达谱2类。另一名睫状体黑色素瘤病例3号染色体单体检测为阴性。无局部治疗失败病例。术后1年时，术前平均眼压从30.5±7.7 mmHg降至15.9±8.1 mmHg（1年成功率80%）。
我们的病例系列中位随访时间为2年，结果显示在接受过治疗的葡萄膜黑色素瘤患者中植入GDD不会使患者面临更高的局部或眼外复发风险。需要更大规模的病例系列和更长的随访时间来全面评估在这种临床情况下GDD的安全性。
