Ocular diseases in metastatic cutaneous melanoma: review of 108 consecutive patients in two German tertiary centers.
OBJECTIVE
To analyze the incidence and spectrum of ocular disease in patients with metastatic cutaneous melanoma.


METHODS
One hundred and eight consecutive patients with metastatic cutaneous melanoma were screened for ocular diseases using standardized eye examination, including measurement of visual acuity and intraocular pressure, slit-lamp examination, funduscopy in mydriasis, and spectral-domain optical coherence tomography (SDOCT) of the retina. Selected cases with atypical findings underwent electrophysiological studies. One patient was examined for hypercortisolism by a dexamethasone suppression test.


RESULTS
Ocular diseases were found in 65 out of 108 patients (60 %) with metastatic cutaneous melanoma, significantly more often in older patients (p = 0.004). Cataract was present in 27 patients (25 %), pseudophakia in 22 patients (20 %), macular disease in 29 patients (28 %), diabetic retinopathy in ten patients (9 %), hypertensive retinal disease in 14 patients (13 %), retinal venous and arterial occlusive disease in three patients (3 %), optic neuropathy in four patients (4 %), and uveitis in one patient (1 %). Eight patients (8 %) had choroidal or iridal nevi, one patient (1 %) choroidal hemangioma, and one patient (1 %) choroidal metastasis. No patient had periocular neoplastic lesions. Paraneoplastic retinopathy manifesting as acute exudative polymorphous vitelliform maculopathy (AEPVM)-like disease was diagnosed in two patients (2 %) with multifocal central serous chorioretinopathy and development of vitelliform or fibrin-like subretinal deposits in one patient.


CONCLUSIONS
Patients with metastatic cutaneous melanoma reveal ocular diseases with a spectrum similar to the normal population of this age range. Very rarely, uveal metastasis as well as paraneoplastic retinopathy can occur.
Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany, r_grajewski@yahoo.com.
Rafael S
RS
Grajewski
Beatrice
B
Schuler-Thurner
Cornelia
C
Mauch
Nicole
N
Kreuzberg
Konrad R
KR
Koch
Antonio
A
Bergua
Claus
C
Cursiefen
Ludwig M
LM
Heindl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005134:Eye Neoplasms / Q000556:secondary; D005260:Female; D005451:Fluorescein Angiography; D005858:Germany; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D062606:Tertiary Care Centers; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology