title: The impact of intravitreal bevacizumab therapy on choroidal melanoma.
abstract: OBJECTIVE
  To describe the clinical course and ancillary findings of 3 patients with choroidal melanoma who inadvertently received multiple intravitreal injections of bevacizumab for a presumed diagnosis of choroidal neovascular membrane.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Three patients with choroidal melanomas who received a series of monthly intravitreal injections of bevacizumab for presumed choroidal neovascularization were evaluated. Clinical, ultrasonographic, and angiographic findings are presented. Histopathologic features are correlated with clinical features in 2 patients who underwent enucleation.
  
  
  RESULTS
  Lack of benefit in halting tumor progression was observed in all 3 cases. In 2 cases treated with enucleation, there was evidence of bevacizumab-induced gliotic/fibrotic retinal changes.
  
  
  CONCLUSIONS
  We present 3 cases of choroidal melanomas that showed progression while patients received multiple intravitreal injections of bevacizumab. The use of the drug led to the formation of a gliotic/fibrotic membrane that resulted in masking of the underlying tumor and consequently delayed the correct diagnosis.
authors.affiliation: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Breno R
authors.initials: BR
authors.lastname: Lima
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Schoenfield
authors.forename: Arun D
authors.initials: AD
authors.lastname: Singh
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy; D003951:Diagnostic Errors; D015353:Eye Enucleation; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005451:Fluorescein Angiography; D005911:Gliosis / Q000473:pathology; D006801:Humans; D058449:Intravitreal Injections; D008545:Melanoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D019233:Retreatment; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab