期刊
OCULAR IMMUNOLOGY AND INFLAMMATION
卷 30, 期 2, 页码 330-337出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/09273948.2020.1813782
关键词
Acute exudative polymorphous paraneoplastic vitelliform maculopathy; immunotherapy; metastatic melanoma; optical coherence tomography; fundus autofluorescence
资金
- Foundation Fighting Blindness [CD-C-0918-0748-EEC]
- Winship Cancer Institute Start Up Funds
AEPPVM is an uncommon paraneoplastic retinopathy found in patients with metastatic malignancy. To our knowledge, this is the first report demonstrating a temporal association between metastatic disease activity and quantifiable changes in retinal imaging over a 4-year period.
Purpose Longitudinal evaluation of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) following diagnosis and treatment of metastatic melanoma. Methods Case report of a 47-year-old male with unknown primary metastatic melanoma and AEPPVM monitored before and during melanoma treatment using clinical exam, retinal imaging, and electroretinograms (ERG). Genetic testing and autoantibody panels were performed. Results He presented within a month of metastatic melanoma diagnosis with numerous bilateral vitelliform lesions in the posterior pole, consistent with AEPPVM. Metastatic disease was treated with immunotherapy, radiosurgery, and radiation over 48 months. Maculopathy and metastatic disease improved and worsened in parallel. Genetic testing was negative for bestrophin-1. An autoantibody panel was positive for anti-recoverin and transducin-alpha. Conclusion AEPPVM is an uncommon paraneoplastic retinopathy found in patients with metastatic malignancy. To our knowledge, this is the first report demonstrating a temporal association between metastatic disease activity and quantifiable changes in retinal imaging over a 4-year period.
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