J Lee, Sanjay Logani, et al (N. W. Univ Med School, Chicago)
Preretinal Neovascularisation Associated with Choroidal Melanoma
BJO, Nov.2001, 85(11): 1309-1312
The authors report 3 cases of choroidal melanoma with the very rare finding of overlying pre-retinal neovascularisation (NVE).
All 3 patients had choroidal melanomas, localized serous retinal detachment and NVE.
Two cases showed definite retinal capillary non-perfusion. One of these two patients showed retinal telangiectasis.
One patient’s melanoma responded quickly to iodine-125 plaque radiotherapy but retinal neovascularization persisted and caused vitreous hemorrhage.
Scatter photocoagulation was successful in causing the complete regression of neovascularization.
The other 2 patients had their eyes enucleated, and in one of the cases preretinal vessels were seen in histological sections.
Possible aetiologies of pre-retinal neovascularization include (i) release of tumor angiogenic factors (ii) inflammation (iii) chronic retinal detachment with secondary retinal ischemia (iv) retinal vascular occlusion secondary to retinal vessel invasion by the tumor or (v) following radiation therapy.
L Lumbroso, L Desjardins, et al (Opth.Dept. Institute Curie, Paris, France)
Intraocular inflammation after proton beam irradiation for uveal melanoma
BJO, 2001; 85:1305-1308
Data from a cohort of patients with uveal melanoma who were treated by proton beam irradiation between 1991 and 1994 were analyzed.
28% of patients treated during the above period presented with ocular inflammation.
Risk factors were correlated with larger lesions. Multivariate analysis identified initial tumour height and irradiation of a large ocular volume as 2 important risk factors.
Ocular inflammation usually consisted of mild anterior uveitis, which resolved rapidly after use of local steroids and cycloplegics.
Inflammation may also be associated with tumour necrosis (spontaneous or after irradiation). Transient inflammation during follow-up of these patients maybe related to release of cytokines during tumour necrosis.