1
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Ryu C, Havens SJ, Chen J, DiMaio DJ, Rishi P. A Case of Bilateral Diffuse Uveal Melanocytic Proliferation Followed by Massive Unilateral Uveal Proliferation. Ocul Immunol Inflamm 2024:1-7. [PMID: 38771975 DOI: 10.1080/09273948.2024.2355577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/10/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) followed by massive unilateral uveal proliferation. METHODS Retrospective case report. RESULTS A 47-year-old female with history of metastatic ovarian carcinoma initially presented with bilateral vision loss and multifocal red patches on posterior poles consistent with BDUMP. Five years later, she presented with bilateral neovascular glaucoma and unilateral iris and ciliary body mass concerning for malignancy. Enucleation revealed diffuse uveal growth involving almost the entirety of the uveal tract. CONCLUSIONS BDUMP can rarely be associated with uveal proliferation. Routine examinations are recommended to monitor for any changes concerning malignancy.
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Affiliation(s)
- Christine Ryu
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Shane J Havens
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jie Chen
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Dominick J DiMaio
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Pukhraj Rishi
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
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2
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Kalogeropoulos D, Afshar F, De Salvo G, Rennie CA, Lotery AJ. Diagnostic and therapeutic considerations in patients with bilateral diffuse uveal melanocytic proliferation. Int Ophthalmol 2024; 44:149. [PMID: 38502258 DOI: 10.1007/s10792-024-03087-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/23/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of bilateral diffuse uveal melanocytic proliferation (BDUMP). METHODS A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items. Our search strategy utilized the following keywords: "bilateral diffuse uveal melanocytic proliferation", "BDUMP", and "Paraneoplastic Syndrome". Articles were considered based on their relevance, with the search spanning publications up to 2023. Studies were excluded if they did not contribute pertinent information or lacked methodological rigor. A critical appraisal of included studies was conducted, assessing study design, sample size, methodology, and potential bias, ensuring a thorough and transparent review process. RESULTS BDUMP is a rare and potentially sight-threatening condition characterized by the bilateral proliferation of melanocytes within the uvea. BDUMP is typically observed in middle-aged or elderly individuals and is often associated with an underlying malignancy, most commonly of gastrointestinal origin. BDUMP is frequently misdiagnosed as a benign nevus or choroidal metastasis, leading to delayed diagnosis and treatment. The ophthalmic symptoms and signs typically precede the diagnosis of a systemic malignancy, emphasizing the crucial role of ophthalmologists in the recognition of BDUMP. Several diagnostic modalities can aid in the diagnosis of BDUMP, including ophthalmic examination, imaging studies such as optical coherence tomography, fluorescein angiography, and indocyanine green angiography, and biopsy of the uveal tissue. Treatment of BDUMP is directed towards the underlying malignancy and may include chemotherapy, radiotherapy, or surgical resection. Additionally, strict monitoring with regular follow-ups may contribute to the detection of new lesions and the reduction in the size of existing ones. CONCLUSIONS BDUMP can be considered a potential biomarker in the management of malignancies, especially when the primary underlying tumor has not been detected. Further research is needed to better understand the pathogenesis of BDUMP and its association with malignancy.
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Affiliation(s)
| | - Farid Afshar
- Southampton Eye Unit, University Hospital Southampton, Tremona Rd, Southampton, SO16 6YD, UK
| | - Gabriella De Salvo
- Southampton Eye Unit, University Hospital Southampton, Tremona Rd, Southampton, SO16 6YD, UK.
| | - Christina A Rennie
- Southampton Eye Unit, University Hospital Southampton, Tremona Rd, Southampton, SO16 6YD, UK
| | - Andrew John Lotery
- Southampton Eye Unit, University Hospital Southampton, Tremona Rd, Southampton, SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
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3
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Yang X, Wang R, Zhou H, Yu S. Bilateral diffuse uveal melanocytic proliferation secondary to combined hepatocellular-cholangiocarcinoma. Asia Pac J Ophthalmol (Phila) 2024; 13:100051. [PMID: 38503393 DOI: 10.1016/j.apjo.2024.100051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Xiaolu Yang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai 200080, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Ruonan Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai 200080, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai 200080, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Suqin Yu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai 200080, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China.
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4
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Medina FMC, Reis RA, Pereira MDCG, Gameiro Filho AR. UNILATERAL DIFFUSE UVEAL MELANOCYTIC PROLIFERATION: CASE REPORT AND BRIEF REVIEW. Retin Cases Brief Rep 2024; 18:184-188. [PMID: 36053838 DOI: 10.1097/icb.0000000000001350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To report a case of unilateral diffuse uveal melanocytic proliferation, in a patient with history of breast cancer, with bone and hepatic metastasis. METHODS Case report with funduscopic examination, fundus autofluorescence, and spectral-domain optical coherence tomography. RESULTS A 57-year-old female patient attended at our clinic for a routine glaucoma follow-up. Fundoscopy was normal on the right eye and showed multiple red patches in the posterior pole and inferior arcade. Multimodal examination was performed, compatible to diffuse uveal melanocytic proliferation on her left eye, and excluding other conditions, such as choroidal metastasis. CONCLUSION Diffuse uveal melanocytic proliferation is a rare paraneoplastic condition, which usually is presented bilaterally. Unilateral cases of diffuse uveal melanocytic proliferation have been previously described only 5 times on the literature and are usually associated with breast cancer.
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Affiliation(s)
- Flávio Mac Cord Medina
- Ophthalmology Department Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rua Sacadura Cabral, Saúde, Rio de Janeiro, Brazil
- Ophthalmology Department Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, Vila Isabel, Rio de Janeiro, Brazil; and
| | - Raphael Araujo Reis
- Ophthalmology Department Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rua Sacadura Cabral, Saúde, Rio de Janeiro, Brazil
| | - Manoella da Cunha Gomes Pereira
- Ophthalmology Department Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rua Sacadura Cabral, Saúde, Rio de Janeiro, Brazil
| | - Aluisio Rosa Gameiro Filho
- Ophthalmology Department Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rua Sacadura Cabral, Saúde, Rio de Janeiro, Brazil
- Ophthalmology and Visual Sciences Department, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), R. Botucatu, Vila Clementino, São Paulo, Brazil
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5
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Dutta Majumder P, Khetan V, Biswas J. Masquerade syndrome: A review of uveitic imposters. Asia Pac J Ophthalmol (Phila) 2024; 13:100054. [PMID: 38583526 DOI: 10.1016/j.apjo.2024.100054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Masquerade syndromes in uveitis are complex clinical conditions where non-inflammatory diseases mimic uveitic manifestations, often leading to diagnostic and therapeutic challenges. This review delves into the diverse spectrum of masquerade syndromes, categorizing them into neoplastic and non-neoplastic entities. We explore the prevalence of primary intraocular lymphoma, leukaemia, retinoblastoma, and other malignancies, as well as conditions like retinitis pigmentosa and endophthalmitis that can present as uveitis. Through detailed analysis of symptoms, diagnostic methods, and treatment approaches, the review emphasizes the importance of considering masquerade syndromes in differential diagnoses to prevent mismanagement. The synthesis of current knowledge aims to enhance clinicians' ability to discern these complex presentations, advocating for a multidisciplinary approach to diagnosis and care, thereby improving patient outcomes in cases of uveitic masquerade syndromes.
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Affiliation(s)
| | | | - Jyotirmay Biswas
- Department of Uveitis & Ocular Pathology, Sankara Nethralaya, Chennai, India.
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6
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Feenstra HMA, van Dijk EHC, Cheung CMG, Ohno-Matsui K, Lai TYY, Koizumi H, Larsen M, Querques G, Downes SM, Yzer S, Breazzano MP, Subhi Y, Tadayoni R, Priglinger SG, Pauleikhoff LJB, Lange CAK, Loewenstein A, Diederen RMH, Schlingemann RO, Hoyng CB, Chhablani JK, Holz FG, Sivaprasad S, Lotery AJ, Yannuzzi LA, Freund KB, Boon CJF. Central serous chorioretinopathy: An evidence-based treatment guideline. Prog Retin Eye Res 2024; 101:101236. [PMID: 38301969 DOI: 10.1016/j.preteyeres.2024.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024]
Abstract
Central serous chorioretinopathy (CSC) is a relatively common disease that causes vision loss due to macular subretinal fluid leakage and it is often associated with reduced vision-related quality of life. In CSC, the leakage of subretinal fluid through defects in the retinal pigment epithelial layer's outer blood-retina barrier appears to occur secondary to choroidal abnormalities and dysfunction. The treatment of CSC is currently the subject of controversy, although recent data obtained from several large randomized controlled trials provide a wealth of new information that can be used to establish a treatment algorithm. Here, we provide a comprehensive overview of our current understanding regarding the pathogenesis of CSC, current therapeutic strategies, and an evidence-based treatment guideline for CSC. In acute CSC, treatment can often be deferred for up to 3-4 months after diagnosis; however, early treatment with either half-dose or half-fluence photodynamic therapy (PDT) with the photosensitive dye verteporfin may be beneficial in selected cases. In chronic CSC, half-dose or half-fluence PDT, which targets the abnormal choroid, should be considered the preferred treatment. If PDT is unavailable, chronic CSC with focal, non-central leakage on angiography may be treated using conventional laser photocoagulation. CSC with concurrent macular neovascularization should be treated with half-dose/half-fluence PDT and/or intravitreal injections of an anti-vascular endothelial growth factor compound. Given the current shortage of verteporfin and the paucity of evidence supporting the efficacy of other treatment options, future studies-ideally, well-designed randomized controlled trials-are needed in order to evaluate new treatment options for CSC.
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Affiliation(s)
- Helena M A Feenstra
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institution, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Hideki Koizumi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Giuseppe Querques
- Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Susan M Downes
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Suzanne Yzer
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark P Breazzano
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA; Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ramin Tadayoni
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, Paris, France
| | - Siegfried G Priglinger
- Department of Ophthalmology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Laurenz J B Pauleikhoff
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Clemens A K Lange
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Roselie M H Diederen
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinier O Schlingemann
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Ocular Angiogenesis Group, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jay K Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Sobha Sivaprasad
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lawrence A Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, USA; Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
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7
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Drača N, Orešković EG, Lazić R, Vukojević M, Radolović Bertetić A, Vukojević N. Management of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP)-A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2158. [PMID: 38138261 PMCID: PMC10745080 DOI: 10.3390/medicina59122158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/27/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: This study reports a case of a 62-year-old patient experiencing a significant decline in vision over the past three months. The initial best-corrected visual acuity (BCVA) of 20/20 in both eyes diminished to 20/200 in the right eye (RE) and counting fingers (CF) in the left eye (LE) within this timeframe. The patient was diagnosed with stage 4 ovarian cancer just one month before the significant vision deterioration. Materials and Methods: A thorough ophthalmologic examination revealed a notable progression of cataracts and the presence of subretinal fluid on the posterior pole, accompanied by choroidal thickening. The right eye exhibited multifocal, orange-pigmented, and elevated choroidal lesions, while the left eye's fundus examination was impeded by dense cataracts. Optical coherence tomography (OCT) revealed bilateral choroidal thickening with overlying folds and subretinal fluid, and ultrasound imaging of the choroidal lesions indicated moderate homogenous internal reflectivity. Results: The patient received a diagnosis of BDUMP (bilateral diffuse uveal melanocytic proliferation), a paraneoplastic syndrome marked by simultaneous, bilateral, painless vision loss and the rapid onset of bilateral cataracts with serous retinal detachments. Despite cataract extraction, the expected visual recovery was not achieved (RE: CF; LE: 2/200, respectively). Plasmapheresis showed some success in stabilizing vision loss attributed to serous retinal detachments. Conclusions: BDUMP necessitates addressing the underlying malignancy for effective treatment. Left untreated, it can lead to near blindness within a year. The prognosis remains grim, with an average survival time ranging from 12 to 15.7 months from the time of diagnosis. Considering this case report, it is crucial to establish effective management plans and further investigate potential treatment methods and predictive markers centered around BDUMP. Collaboration between healthcare professionals and researchers is crucial in addressing the complexities of BDUMP, as the timely diagnosis and treatment of the disease remains a top priority.
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Affiliation(s)
- Nataša Drača
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Emma Grace Orešković
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Ratimir Lazić
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Marija Vukojević
- Department of Ophthalmology, General Hospital Pula, 52100 Pula, Croatia;
- Institute of Emergency Medicine of Sisak-Moslavina County, 44000 Sisak, Croatia
| | | | - Nenad Vukojević
- Department of Opthalmology, University Hospital Rebro, 10000 Zagreb, Croatia; (A.R.B.); (N.V.)
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8
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Saturno MC, Neri P, Pichi F. Fundus autofluorescence in uveitis: from pathogenesis to imaging interpretation. Int Ophthalmol 2023; 43:4359-4371. [PMID: 37418226 DOI: 10.1007/s10792-023-02803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This review aims to summarize the current fundus autofluorescence (FAF) ailment for diagnosis and follow-up of uveitis. METHODS A thorough literature search was performed in the PubMed database. RESULTS FAF maps the retinal pigment epithelium's (RPE) health. Therefore, several posterior infectious and non. This fast, easy-to-perform, noninvasive technique can detect and manage infectious uveitis. CONCLUSIONS FAF serves to understand pathophysiologic mechanisms of uveitis and is a valuable prognostic indicator of themselves.
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Affiliation(s)
| | - Piergiorgio Neri
- Eye Insitute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Francesco Pichi
- Eye Insitute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
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9
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Allon G, Zhi Heng L, Imseeh G, da Cruz L, Yeung IYL. Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP) associated with adenocarcinoma of the prostate. J Fr Ophtalmol 2023; 46:e306-e307. [PMID: 37481447 DOI: 10.1016/j.jfo.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/10/2023] [Indexed: 07/24/2023]
Affiliation(s)
- G Allon
- Retina Service, Moorfields Eye Hospital, 162, City Road, EC1V 2PD London, United Kingdom.
| | - L Zhi Heng
- Retina Service, Moorfields Eye Hospital, 162, City Road, EC1V 2PD London, United Kingdom
| | - G Imseeh
- Department of Oncology, North Middlesex University Hospital, Sterling Way, N18 1QX London, United Kingdom
| | - L da Cruz
- Retina Service, Moorfields Eye Hospital, 162, City Road, EC1V 2PD London, United Kingdom
| | - I Y L Yeung
- Retina Service, Moorfields Eye Hospital, 162, City Road, EC1V 2PD London, United Kingdom
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10
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Kallel M, Zaka G, Rosentreter A, Siggel R. [Bilateral diffuse uveal melanocytic proliferation with metastatic bronchial carcinoma (case report)]. DIE OPHTHALMOLOGIE 2023; 120:656-659. [PMID: 35925341 DOI: 10.1007/s00347-022-01675-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 06/13/2023]
Affiliation(s)
- Mourad Kallel
- Augenklinik, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
| | - Gloria Zaka
- Augenklinik, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - André Rosentreter
- Augenklinik, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - Robert Siggel
- Augenklinik, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
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11
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Zhao F, Hu L, Guo R, Li Z, Ji J, Liu W. Bilateral Diffuse Uveal Melanocytic Proliferation Initially Presented as Glaucoma. Ocul Immunol Inflamm 2023; 31:601-608. [PMID: 35201969 DOI: 10.1080/09273948.2022.2032201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/31/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To report a bilateral diffuse uveal melanocytic proliferation (BDUMP) patient whose initial presentation was glaucoma. METHODS Clinical review of a BDUMP case. RESULTS A 65-year-old woman presented with ocular pain of the left eye for 1 day and vision loss of the right eye for 1 week. An ophthalmological examination revealed increased intraocularr pressure in the left eye and shallow anterior chamber in both eyes. BDUMP was diagnosed following a series of auxiliary examinations. After 1.5 years of follow-up, progressive cataracts appeared, and the patient accepted cataract surgery in both eyes. Visual acuity improved from light perception to 20/100 in both eyes 1.5 years after cataract surgery, but declined to light perception again at the last follow-up. CONCLUSION BDUMP can be initially presented as glaucoma, and cataract surgery can be considered in BDUMP patients in order to improve the patients' quality of life, even if exudative retinal detachment exists.
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Affiliation(s)
- Fangyu Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Liying Hu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Zhiqing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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12
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Lentzsch AM, Siggel R, Schnorr C, Holtick U, Liakopoulos S. LONG-TERM FOLLOW-UP OF ASYMMETRIC BILATERAL DIFFUSE UVEAL MELANOCYTIC PROLIFERATION IN A PATIENT WITH METASTASIZED UROTHELIAL CARCINOMA. Retin Cases Brief Rep 2023; 17:105-110. [PMID: 33492075 DOI: 10.1097/icb.0000000000001129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To report a case of bilateral diffuse uveal melanocytic proliferation over 30 months follow-up. METHODS Multimodal imaging including ultra-wide-field color fundus photography, blue light fundus autofluorescence, swept-source optical coherence tomography, fluorescein angiography, and indocyanine green angiography. RESULTS A 49-year-old woman presented with decreased vision 2 months after bladder cancer surgery. Exudative retinal detachment and leopard spot pattern chorioretinopathy were observed in the right eye. Chemotherapy and cystectomy were initiated. Progressive bilateral vision loss occurred with melanocytic proliferation, choroidal thickening, subretinal fibrosis, fluid extravasation, rapid development of mature cataract, multiple iris cysts, and rubeosis, despite plasmapheresis and IV immunoglobulins. After cataract surgery, massive fibrin reaction resulted in a ciliolenticular block. One year later, positron emission tomography-computed tomography revealed absence of metastases. At Month 23, choroidal thickness increased in line with tumor progression. Palliative systemic therapy was initiated. Secondary macular neovascularization was treated with intravitreal antivascular endothelial growth factor injections. Visual acuity was light perception in the right eye and 20/200 in the left eye at last follow-up. CONCLUSION Bilateral diffuse uveal melanocytic proliferation results in progressive melanocyte proliferation and exudation, leading to severe visual loss. In our case, visual acuity was preserved at a low level in one eye under continuous systemic treatment. Systemic corticosteroids are recommended for cataract surgery in the setting of bilateral diffuse uveal melanocytic proliferation to prevent massive fibrin reaction. Intravitreal antivascular endothelial growth factor injections may be indicated if secondary macular neovascularization develops.
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Affiliation(s)
- Anna M Lentzsch
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Robert Siggel
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department of Ophthalmology, Helios University Hospital Wuppertal, University of Witten-Herdecke, Witten, Germany ; and
| | - Christel Schnorr
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Udo Holtick
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sandra Liakopoulos
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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13
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[Mysterious bilateral choroidal pigmentation : A case of a female patient with visual deterioration and bilateral choroidal pigmentation that leads to the discovery of an advanced underlying disease]. DIE OPHTHALMOLOGIE 2023; 120:98-101. [PMID: 35943528 DOI: 10.1007/s00347-022-01696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 01/25/2023]
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14
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Weppelmann TA, Khalil S, Zafrullah N, Amir S, Margo CE. Ocular Paraneoplastic Syndromes: A Critical Review of Diffuse Uveal Melanocytic Proliferation and Autoimmune Retinopathy. Cancer Control 2022; 29:10732748221144458. [PMID: 36473045 PMCID: PMC9732803 DOI: 10.1177/10732748221144458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Dozens of paraneoplastic syndromes affect the visual system ranging from conjunctival pemphigoid to encephalopathy of the occipital cortex. The most profiled ocular syndromes are bilateral diffuse uveal melanocytic proliferation (BDUMP) and the autoimmune retinopathies.Purpose: To review the critical features of these 2 entities then concentrate on advancements in treatment made within the last 10 years.Study Design: Literature review with structured data abstraction.Results: Major insights into pathogenesis have been wanting. Plasmapheresis appears to improve vision in a substantial proportion of patients with BDUMP. The number of clinical variables that influence visual outcome in paraneoplastic retinopathies combined with the variety of local and systemic treatment options makes interpretation of clinical effectiveness difficult.Conclusions: The rarity of these disorders makes randomized clinical trials unlikely. It may be time for a clinical professional organization to use a modified Delphi method to establish a consensus algorithm for the diagnosis and management of retinal paraneoplastic syndromes to augment clinical communications and clinical trials.
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Affiliation(s)
- Thomas A. Weppelmann
- Departments of Ophthalmology,
Morsani
College of Medicine, University of South
Florida, Tampa, FL, USA
| | - Sabrina Khalil
- Departments of Ophthalmology,
Morsani
College of Medicine, University of South
Florida, Tampa, FL, USA
| | - Nabeel Zafrullah
- Departments of Ophthalmology,
Morsani
College of Medicine, University of South
Florida, Tampa, FL, USA
| | - Sabah Amir
- Departments of Ophthalmology,
Morsani
College of Medicine, University of South
Florida, Tampa, FL, USA
| | - Curtis E. Margo
- Departments of Ophthalmology,
Morsani
College of Medicine, University of South
Florida, Tampa, FL, USA,Departments of Pathology and
Molecular Biology, Morsani College of Medicine, University of
South Florida, Tampa, FL, USA,Curtis E. Margo, MD, MPH, Departments of
Ophthalmology, Morsani College of Medicine, University of South Florida, 13330
USF Laurel Dr, Morsani Building 4th Floor Dermatopathology, Tampa, FL 33612,
USA.
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15
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Ando T, Seki M, Ueda E, Suetake A, Terashima H, Yoshida H, Hasebe H, Fukuchi T. A case of bilateral diffuse uveal melanocytic proliferation with secondary angle closure caused by ciliary body thickening. Am J Ophthalmol Case Rep 2022; 28:101729. [PMID: 36324629 PMCID: PMC9619173 DOI: 10.1016/j.ajoc.2022.101729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 08/28/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To describe a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) with secondary angle closure caused by ciliary body thickening accompanied by intraocular pressure (IOP) elevation after mydriasis. Observations A 55-year-old woman with a history of ovarian cancer had blurred vision in both eyes. Fundus examination revealed multiple patchy lesions in both eyes and a nevus-like elevated lesion in the right eye. Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) demonstrated angle closure resulting from ciliary body thickening. After mydriasis, the IOP was elevated in both eyes. Instillation of a miotic drug successfully reversed the IOP to normal levels. Conclusions and Importance BDUMP caused secondary angle closure in both eyes, presumably due to thickening of the entire ciliary body. AS-OCT and UBM were advantageous for analyzing the morphology of the anterior eye segment in BDUMP. Clinicians should be aware of the possibility of angle closure during the management of patients with BDUMP.
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Affiliation(s)
- Takumi Ando
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan,Corresponding author.
| | - Masaaki Seki
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan,Seki Eye Clinic, Niigata, Japan
| | - Eriko Ueda
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Aki Suetake
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroko Terashima
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiromitsu Yoshida
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiruma Hasebe
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan,Department of Ophthalmology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Takeo Fukuchi
- Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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16
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Inoda S, Makino S. Bilateral diffuse uveal melanocytic proliferation. QJM 2022; 116:305-307. [PMID: 36259974 DOI: 10.1093/qjmed/hcac241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 04/05/2023] Open
Abstract
Learning Point for Clinicians Bilateral diffuse uveal melanocytic proliferation (BDUMP) can occur not only in patients with cancer, but also as the first sign of subclinical malignancies. Clinicians should be aware of BDUMP when a patient presents with rapid vision loss with fundus changes.
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Affiliation(s)
- Satoru Inoda
- Department of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shinji Makino
- Department of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan
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17
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Parakh S, Maheshwari S, Das S, Kumar V, Agrawal R, Gupta V, Mruthyunjaya P, Luthra S. Presumed bilateral diffuse uveal melanocytic proliferation – A case report and review of literature. Am J Ophthalmol Case Rep 2022; 27:101582. [PMID: 35619994 PMCID: PMC9127154 DOI: 10.1016/j.ajoc.2022.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 10/26/2022] Open
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18
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Cai ZP, Zhang H, Zhang JJ, Jie CH, Dong FT. Bilateral diffuse uveal melanocytic proliferation associated with endometrial carcinoma - multimodal imaging analysis. Int J Ophthalmol 2022; 15:1209-1213. [PMID: 35919315 DOI: 10.18240/ijo.2022.07.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/02/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Zhi-Peng Cai
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Hong Zhang
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Jin-Jing Zhang
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Chuan-Hong Jie
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Fang-Tian Dong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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19
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Non-vasogenic cystoid maculopathies. Prog Retin Eye Res 2022; 91:101092. [PMID: 35927124 DOI: 10.1016/j.preteyeres.2022.101092] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Besides cystoid macular edema due to a blood-retinal barrier breakdown, another type of macular cystoid spaces referred to as non-vasogenic cystoid maculopathies (NVCM) may be detected on optical coherence tomography but not on fluorescein angiography. Various causes may disrupt retinal cell cohesion or impair retinal pigment epithelium (RPE) and Müller cell functions in the maintenance of retinal dehydration, resulting in cystoid spaces formation. Tractional causes include vitreomacular traction, epiretinal membranes and myopic foveoschisis. Surgical treatment does not always allow cystoid space resorption. In inherited retinal dystrophies, cystoid spaces may be part of the disease as in X-linked retinoschisis or enhanced S-cone syndrome, or occur occasionally as in bestrophinopathies, retinitis pigmentosa and allied diseases, congenital microphthalmia, choroideremia, gyrate atrophy and Bietti crystalline dystrophy. In macular telangiectasia type 2, cystoid spaces and cavitations do not depend on the fluid leakage from telangiectasia. Various causes affecting RPE function may result in NVCM such as chronic central serous chorioretinopathy and paraneoplastic syndromes. Non-exudative age macular degeneration may also be complicated by intraretinal cystoid spaces in the absence of fluorescein leakage. In these diseases, cystoid spaces occur in a context of retinal cell loss. Various causes of optic atrophy, including open-angle glaucoma, result in microcystoid spaces in the inner nuclear layer due to a retrograde transsynaptic degeneration. Lastly, drug toxicity may also induce cystoid maculopathy. Identifying NVCM on multimodal imaging, including fluorescein angiography if needed, allows guiding the diagnosis of the causative disease and choosing adequate treatment when available.
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20
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Sen M, Laiton A, Shields CL. Mucocutaneous Pigmentation in a Patient With Bilateral Diffuse Uveal Melanocytic Proliferation. JAMA Ophthalmol 2022; 140:e222510. [PMID: 35980397 DOI: 10.1001/jamaophthalmol.2022.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This case report discusses a diagnosis of bilateral diffuse uveal melanocytic proliferation in an older adult with a history of metastatic cervical cancer who presented with brown pigmentation of the lips and vision loss.
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Affiliation(s)
- Mrittika Sen
- The Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Andrea Laiton
- The Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Carol L Shields
- The Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
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21
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Kang L, Wan C. Paraneoplastic syndrome in neuroophthalmology. J Neurol 2022; 269:5272-5282. [PMID: 35779086 DOI: 10.1007/s00415-022-11247-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/19/2022] [Accepted: 06/19/2022] [Indexed: 12/16/2022]
Abstract
Paraneoplastic syndrome is a group of clinical symptoms that occur in the state of systemic malignant tumors. Paraneoplastic syndrome of the nervous system can affect any part of the central and peripheral nervous system and may also affect the eyes. In neuroophthalmology, paraneoplastic syndrome has a variety of manifestations that can affect both the afferent and efferent visual systems. The afferent system may involve the optic nerve, retina and uvea; the efferent system may involve eye movement, neuromuscular joints or involuntary eye movements and pupil abnormalities and may also have other neurological symptoms outside the visual system. This article discusses the clinical manifestations, pathological mechanisms, detection methods and treatment methods of paraneoplastic syndrome in neuroophthalmology. The performance of paraneoplastic syndrome is diverse, the diagnosis is difficult, and the treatment should be considered systematically. Differential diagnosis, optimal evaluation and management of these manifestations is not only the key to treatment but also a challenge.
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Affiliation(s)
- Longdan Kang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Chao Wan
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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22
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Bilateral diffuse uveal melanocytic proliferation (BDUMP) as ocular toxicity from durvalumab in advanced renal carcinoma. Eur J Cancer 2022; 171:10-12. [PMID: 35709599 DOI: 10.1016/j.ejca.2022.04.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022]
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23
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Kiryakoza LC, Diaz JD, Priluck J, Davis J, Yannuzzi NA. A Case of Bilateral Diffuse Uveal Melanocytic Proliferation in the Setting of Urothelial Carcinoma of the Ureter: A Failed Response to Plasmapheresis. Ophthalmic Surg Lasers Imaging Retina 2022; 53:350-353. [PMID: 35724372 DOI: 10.3928/23258160-20220604-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome. Diagnosis can be difficult and treatment guidelines are ill-defined. A 73-year-old man with poorly differentiated high grade urothelial carcinoma of the ureter metastatic to the liver, lungs, lymph nodes, and pelvis treated with chemotherapy and immunotherapy reported gradual vision loss. Optical coherence tomography (OCT) demonstrated intraretinal and subretinal fluid with hyperreflective subretinal deposits and focal, deeply pigmented choroidal lesions. Irregular hyperpigmentation of the retinal pigment epithelium (RPE) with a "leopard spot" pattern on fundus autofluorescence (FAF) supported the diagnosis of BDUMP. Multiple plasmapheresis sessions did not result in sustained clinical improvement. [Ophthalmic Surg Lasers Imaging Retina 2022;53(6): 350-353.].
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24
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Vieyres B, Chiambaretta F, Navel V. Bilateral diffuse uveal melanocytic proliferation: A case report. J Fr Ophtalmol 2022; 45:e268-e270. [DOI: 10.1016/j.jfo.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022]
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25
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Shah M, Pradhan A, Dutta Majumder P. Leopard retinopathy: An unusual presentation of sympathetic ophthalmia. Eur J Ophthalmol 2022; 33:NP131-NP135. [PMID: 35266403 DOI: 10.1177/11206721221085851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report an unusual case of sympathetic ophthalmia (SO) in an elderly gentleman following multiple eye surgeries. He presented with diffuse granulomatous panuveitis resembling leopard retinopathy in the left eye. There was a delay in the initiation of effective treatment of his intraocular inflammation, but he responded to corticosteroid and azathioprine. The pigmentary changes in his fundus were highly unusual, and he was investigated extensively to rule out other possible causes including a search for occult malignancy. The delay in initiation of effective treatment or suboptimal therapy in SO, can lead to variable clinical picture in elderly patients. A proper screening to exclude any malignancy along with aggressive immunosuppressive therapy can achieve optimum results.
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Affiliation(s)
- Mauli Shah
- Medical and Vision Research Foundations, 29853Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Arkaprava Pradhan
- Medical and Vision Research Foundations, 29853Sankara Nethralaya, Chennai, Tamil Nadu, India
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26
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Bilateral diffuse uveal melanocytic proliferation: Report of a novel optical coherence tomography finding and clinical response to plasmapheresis. Am J Ophthalmol Case Rep 2022; 25:101349. [PMID: 35243136 PMCID: PMC8859800 DOI: 10.1016/j.ajoc.2022.101349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/11/2021] [Accepted: 01/23/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose To describe a novel optical coherence tomography (OCT) finding in a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) and to report the clinical response to plasmapheresis. Observations We report the case of a 54-year-old man who was being treated with adjuvant immune checkpoint inhibitors for metastatic renal cell carcinoma. He had suffered from bilateral progressive vision loss without ocular pain. At presentation in the retina clinic, visual acuity was counting fingers bilaterally. Examination revealed characteristic findings suggestive of a peculiar paraneoplastic intraocular syndrome called BDUMP. Multiple choroidal nevi-like melanocytic tumors were noted bilaterally. The diagnosis was confirmed using multimodal imaging with fluorescein angiography and fundus autofluorescence, which revealed a typical leopard pattern. Ultrasonography revealed choroidal thickening extending to the ciliary body. OCT showed multiple pockets of serous retinal detachment (SRD) and bacillary layer detachment (BALAD), a newly recognized and rarely described manifestation of the disease. The clinical response to plasmapheresis was robust with resolution of the BALAD and SRD and improvement of the vision to 20/30 in both eyes at the seven-month follow-up. Conclusions and importance BALAD is a newly recognized manifestation of BDUMP. Early recognition of this paraneoplastic syndrome and prompt initiation of plasmapheresis has the potential to improve and stabilize vision.
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27
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Chung W, Kim SH, Choi Y, Choi SK, Lee JJ, Park SW, Byon IS. An Adenocarcinoma Associated with Bilateral, Diffuse, Uveal Melanocytic Proliferation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We report bilateral, diffuse, uveal melanocytic proliferation caused by a stomach adenocarcinoma.Case summary: A 78-year-old male complained of visual impairment 3 months in duration. He had diabetes and had undergone cataract surgery on both eyes 4 years prior. His best-corrected visual acuity was counting fingers in the right eye and 20/160 in the left eye. Both intraocular pressures were normal. The anterior segments yielded no specific findings. The maculae exhibited multiple, round, patchy, pigmented or depigmented lesions with exudative retinal detachment. Fluorescein angiography revealed multiple hyperfluorescent lesions. Optical coherence tomography revealed that the hyper-reflective exudates lay between the neurosensory retina and the retinal pigment epithelium. We diagnosed bilateral, diffuse, uveal melanocytic proliferation and performed a systemic evaluation. Computed tomography revealed several mass lesions in the lung, stomach, and lymph nodes; these appeared to be malignant. An esophagogastroduodenoscopic biopsy confirmed that the lesions were adenocarcinomas.Conclusions: A bilateral, diffuse, uveal melanocytic proliferation induced by a primary malignant tumor exhibited multiple, pigmented subretinal exudates associated with exudative macular retinal detachment. In patients with such findings, it is necessary to evaluate the malignant tumor status of remote organs.
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28
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Da Silva MV, Rose K, Krema H. Pigment-induced glaucoma secondary to bilateral diffuse uveal melanocytic proliferation. Eur J Ophthalmol 2022; 32:NP62-NP65. [DOI: 10.1177/1120672120953076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report the first case of pigment-induced glaucoma in a patient presenting with bilateral diffuse uveal melanocytic proliferation (BDUMP) syndrome. Despite treatment with plasma exchange, the patient developed progression of her lesions and bilateral glaucoma. Surgical treatment with Ahmed valve implant was performed to control her increased intra-ocular pressure. This case demonstrates that BDUMP can be a cause of a refractory pigment-induced glaucoma.
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Affiliation(s)
- Maria Valeria Da Silva
- Princess Margaret Cancer Center/University Health Network, Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada
| | - Kalpana Rose
- Princess Margaret Cancer Center/University Health Network, Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada
| | - Hatem Krema
- Princess Margaret Cancer Center/University Health Network, Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada
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Prasuhn M, Rommel N, Kakkassery V, Grisanti S, Ranjbar M, Rommel F. Rare Case of Bilateral Diffuse Uveal Melanocytic Proliferation with Dermal and Mucosal Hyperpigmentations. Diagnostics (Basel) 2021; 11:diagnostics11112052. [PMID: 34829399 PMCID: PMC8619430 DOI: 10.3390/diagnostics11112052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: The demonstration of a rare case of bilateral diffuse uveal melanocytic proliferation (BDUMP) due to a lung carcinoma with unusual dermal lesions. Case description: A 76-year-old man with painless bilateral vision loss revealed leopard or giraffe spot chorioretinopathy and bilateral serous retinal detachment. Ultrasound biomicroscopy revealed uveal swelling expanding into the anterior chamber angle. Dermal and mucosal lesions were present on the lip, breast, groin, scrotum, and penis. Screening analyses revealed a non-small cell lung carcinoma. Conclusions: The diagnosis of BDUMP, a rare paraneoplastic syndrome, was made. The ophthalmological diagnosis led to screening investigations and revealed the underlying malignant disease. Uncommonly, multiple dermal and mucosal lesions could be detected and were analyzed histopathologically.
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Affiliation(s)
- Michelle Prasuhn
- Department of Ophthalmology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; (V.K.); (S.G.); (M.R.); (F.R.)
- Correspondence: ; Tel.: +49-451-500-43900
| | - Nathalie Rommel
- Department of Dermatology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany;
| | - Vinodh Kakkassery
- Department of Ophthalmology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; (V.K.); (S.G.); (M.R.); (F.R.)
| | - Salvatore Grisanti
- Department of Ophthalmology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; (V.K.); (S.G.); (M.R.); (F.R.)
| | - Mahdy Ranjbar
- Department of Ophthalmology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; (V.K.); (S.G.); (M.R.); (F.R.)
| | - Felix Rommel
- Department of Ophthalmology, University of Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; (V.K.); (S.G.); (M.R.); (F.R.)
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30
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Miyata M, Ooto S, Hata M, Takahashi A, Tsujikawa A. Efficacy of combined anti-VEGF and photodynamic therapy for bilateral diffuse uveal melanocytic proliferation: Case series. Medicine (Baltimore) 2021; 100:e27578. [PMID: 34678904 PMCID: PMC8542108 DOI: 10.1097/md.0000000000027578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/07/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Bilateral diffuse uveal melanocytic proliferation (BDUMP) is an extremely rare retinal exudative disease with physical disorders and no established treatment standard. We describe treatment courses in 3 cases of BDUMP. PATIENTS CONCERNS Three male patients complained active vision loss. One male patient in his 70s (patient 1) was treated with prednisolone, mesalazine, and ciclosporin for hypoplastic anemia and ulcerous colitis. One male patient in his 60s (patient 2) was on prednisolone therapy for adult Still disease. Another male patient in his 70s (patient 3) was on prednisolone therapy for polymyalgia rheumatica, giant cell arteritis, and pancreatic body tumor. DIAGNOSES Retinal specialists diagnosed these patients with BDUMP based on characteristic fundus findings of multiple red patches and retinal exudate. INTERVENTIONS Two patients (patients 1 and 2) with poor response to anti-vascular endothelial growth factor (VEGF) monotherapy and/or triamcinolone acetonide sub-Tenon injection were treated with combined anti-VEGF therapy and photodynamic therapy. One patient (patient 3) was treated with 3 rounds of monthly anti-VEGF monotherapy. OUTCOMES Retinal exudates were resolved in all patients. No recurrence of retinal exudates was observed for at least 10 months, 2 years, or 4 months after the therapy in patients 1, 2, and 3, respectively. However, best-corrected visual acuity of the right eye was low (20/200) compared with that of the left eye (20/22) in patient 2 despite exudate resolution, due to permanent outer retinal damage secondary to long-term retinal exudate. LESSONS SUBSECTIONS Combined anti-VEGF therapy and photodynamic therapy may be a feasible therapeutic option for treatment-resistant exudate in patients with BDUMP. Early diagnosis of BDUMP and prompt administration of combination therapy are crucial.
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Affiliation(s)
- Manabu Miyata
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Hata
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montreal, Canada
- Biochemistry and Molecular Medicine, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montreal, Canada
| | - Ayako Takahashi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Böcskei Z, Viinikka E, Dormegny L, Bigaut K, Speeg C. [Paraneoplastic ophthalmopathies]. J Fr Ophtalmol 2021; 45:119-136. [PMID: 34598825 DOI: 10.1016/j.jfo.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Ocular paraneoplastic syndromes are rare conditions that can affect any part of the eye at any age. Thus, every ophthalmologist should be familiar with their management, as some of them may reveal severe, life-threatening conditions. These consist overwhelmingly of neuro-ophthalmological manifestations, affecting the optic nerve (paraneoplastic optic neuritis), retina (paraneoplastic retinopathy) or neurological pathways generating eye movements (saccadic intrusion, oculomotor palsy, nystagmus...); occasionally, they involve the anterior segment, orbit or uveal tract. As some of these manifestations appear to be quite common and non-specific, any systemic or especially neurologic comorbidities should increase suspicion. Treatment relies first on oncologic management, and then often more targeted therapy for the associated immune involvement.
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Affiliation(s)
- Z Böcskei
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67000 Strasbourg, France; Service de neurologie, hôpitaux universitaires de Strasbourg, 1, avenue de Molière, 67200 Strasbourg, France.
| | - E Viinikka
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67000 Strasbourg, France
| | - L Dormegny
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67000 Strasbourg, France
| | - K Bigaut
- Service de neurologie, hôpitaux universitaires de Strasbourg, 1, avenue de Molière, 67200 Strasbourg, France
| | - C Speeg
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67000 Strasbourg, France
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Sharma M, Yangzes S, Singh SR, Dogra M. Bilateral Diffuse Uveal Melanocytic Proliferation in a Patient with Recurrent Frontal Lobe Meningioma. Ocul Immunol Inflamm 2021; 30:1172-1175. [PMID: 34424118 DOI: 10.1080/09273948.2020.1859550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Bilateral diffuse uveal melanocytic proliferation (B-DUMP) is a paraneoplastic disorder that may be seen in patients with a known malignancy but more commonly is seen in those without any history of cancer. It leads to multiple uveal tumors with exudative retinal detachment along with thickening of the choroid and generally carries a poor prognosis. Its etio-pathogenesis is poorly understood but is said to involve factors secreted by the systemic malignancy that lead to proliferation of melanocytes in the uvea.Methods: We report the presentation and management of a female with history of treated frontal lobe meningioma who presented with neovascular glaucoma along with B-DUMP and was found to have recurrence of the meningioma on neuro-imaging.Conclusions: Central nervous system meningiomas can cause B-DUMP and management of the malignancy may lead to partial resolution of posterior segment manifestations of B-DUMP.
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Affiliation(s)
- Manu Sharma
- Health and Family Welfare Department, Civil Hospital Kangra, Kangra, India
| | - Sonam Yangzes
- Anterior segment and Cornea Service, Grewal Eye Institute, Chandigarh, India
| | - Simar Rajan Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohit Dogra
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Paraneoplastic ocular syndrome: a pandora's box of underlying malignancies. Eye (Lond) 2021; 36:1355-1367. [PMID: 34345027 DOI: 10.1038/s41433-021-01676-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
Paraneoplastic syndromes affecting the visual system are a group of conditions that arise in the systemic malignancy framework. In this review, we have provided a detailed and comprehensive overview of the published literature on the various ophthalmic paraneoplastic manifestations. A systematic review of many databases has been performed to identify ample literature on the paraneoplastic syndromes related to ophthalmology. We have discussed here the clinical features, pathogenesis, and treatment strategies of various ophthalmic paraneoplastic syndromes. It can be challenging to distinguish these disorders from their non-paraneoplastic counterparts and to determine the appropriate systemic assessment for the tumour responsible, to have a proper approach towards the management of the syndrome. METHOD: We searched PubMed, Science Direct and Journal of Ophthalmology for studies published in English between 1995 and April 2020, incorporating the general search term "paraneoplastic ocular syndrome" with connecting terms relevant to subheadings-e.g. Key search terms were cancer-associated retinopathy, (CAR), melanoma-associated retinopathy, (MAR), paraneoplastic retinopathy, autoimmune retinopathy, autoimmune-related retinopathy, and optic neuropathy, (ARRON), acute zonal occult outer retinopathy, (AZOOR), paraneoplastic vitelliform maculopathy, paraneoplastic vitelliform retinopathy, bilateral diffuse uveal melanocytic proliferation, (BDUMP), paraneoplastic optic neuropathy, (PON), polyneuropathy, organomegaly, endocrinopathy, monoclona gammopathy, and skin changes syndrome (POEMS) and various other terms. References from identified studies have been reviewed and included if deemed appropriate, valid, and scientifically important. If referenced in a selected English paper, we contemplated papers in other languages too. We preferentially selected papers that have been published in the last 10 years, but we have included relevant older references.
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Breazzano MP, Bacci T, Wang H, Francis JH, Yannuzzi LA. Bacillary Layer Detachment in Bilateral Diffuse Uveal Melanocytic Proliferation Masquerading as Neovascular AMD. Ophthalmic Surg Lasers Imaging Retina 2021; 51:413-417. [PMID: 32706900 DOI: 10.3928/23258160-20200702-07] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/08/2020] [Indexed: 01/26/2023]
Abstract
Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare and unusual paraneoplastic ocular syndrome with generally poor prognosis. The authors present a case of BDUMP in a patient with bladder cancer, examined with current multimodal imaging. In the clinical setting with drusen and exudative macular detachments, the fundus simulated neovascular age-related macular degeneration, warranting standard-of-care therapy. The imaging actually showed the typical manifestations of BDUMP, but also newly recognized, associated manifestations, including the bacillary layer detachment, a gravitating retinal detachment, and multifocal choroidal hyperpermeability, but no evidence of neovascularization. Recognition of these associated manifestations is of value in appreciating the pathophysiology of this paraneoplastic disorder. Based on the imaging, the correct diagnosis was possible along with a better understanding of the nature of the clinical features in the posterior fundus. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:413-417.].
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35
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Tong N, Wang L, Wang N, Zhou Z. Bilateral Diffuse Uveal Melanocytic Proliferation Secondary to Rectal Adenocarcinoma: A Case Report and Literature Review. Front Med (Lausanne) 2021; 8:691686. [PMID: 34355005 PMCID: PMC8329363 DOI: 10.3389/fmed.2021.691686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic intraocular syndrome that causes progressive visual loss in patients, and is associated with an underlying malignancy. Recently, the incidence of BDUMP has increased with the prolonged life expectancy of oncology patients. Case Presentation: We report a case of a 68-year-old man with significant visual loss in both eyes. The patient presented with a diffusely thickened choroid and ciliary body, extremely shallow anterior chamber, increased intraocular pressure, and cataract formation, accompanied by exudative retinal detachment in both eyes. He underwent a pars plana vitrectomy and choroidal biopsy, which revealed benign proliferation of melanocytes. A small amount of subretinal fluid persisted, and uveal thickness persisted in the early postoperative period. During the 1-year follow-up assessment, he underwent rectal tumor resection, and was pathologically diagnosed with rectal adenocarcinoma. Six months after the rectal tumor resection, the subretinal fluid was completely absorbed and the retina had reattached. The thickness of both the ciliary body and choroid had significantly decreased. Conclusion: This case report describes a rare paraneoplastic intraocular syndrome, BDUMP, which was associated with rectal adenocarcinoma. Treatment for the primary malignancy gradually improved the visual symptoms and signs.
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Affiliation(s)
- Nianting Tong
- Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China
| | - Liangyu Wang
- Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China
| | - Nan Wang
- Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China
| | - Zhanyu Zhou
- Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China
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36
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Navarrete-Dechent C, Monnier J, Marghoob NG, Liopyris K, Busam KJ, Francis JH, Marghoob AA. Bilateral diffuse uveal melanocytic proliferation with multifocal diffuse integumentary melanocytic proliferation paraneoplastic syndrome: A case report. Australas J Dermatol 2021; 62:386-389. [PMID: 33974277 DOI: 10.1111/ajd.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/27/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
Bilateral diffuse uveal melanocytic proliferation (B-DUMP) is a rare paraneoplastic syndrome typically presenting with bilateral visual loss. B-DUMP is associated with extraocular systemic malignancies with the most common being lung cancer in males and uro-gynaecological cancer in females (mainly ovarian cancer). Cutaneous and/or mucosal involvement in patients with B-DUMP has been reported but it is not well characterised. Herein, we present a female in her 70s with diagnosis of stage IV vaginal clear-cell carcinoma and metastatic melanoma of unknown primary that developed progressive bilateral loss of visual acuity compatible with 'B-DUMP'. Simultaneously, she developed multifocal bilateral bluish-greyish patches on the skin that were shown to have a proliferation of dermal melanocytes. We propose that the clinical and histopathologic cutaneous findings seen in patients with B-DUMP be termed 'diffuse integumentary melanocytic proliferation (DIMP)'.
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Affiliation(s)
- Cristián Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jilliana Monnier
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Dermatology and Skin Cancer, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Nadeem G Marghoob
- New York Institute of Technology College of Osteopathic Medicine, OMSIII, New York, NY, USA
| | - Konstantinos Liopyris
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Jasmine H Francis
- Ophthalmic Oncology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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37
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60-year-old with Prominent Episcleral Veins and Leopard Spot Fundus. Retina 2021; 42:584-587. [PMID: 33965995 DOI: 10.1097/iae.0000000000003204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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van Dijk EHC, Boon CJF. Serous business: Delineating the broad spectrum of diseases with subretinal fluid in the macula. Prog Retin Eye Res 2021; 84:100955. [PMID: 33716160 DOI: 10.1016/j.preteyeres.2021.100955] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/14/2021] [Accepted: 02/19/2021] [Indexed: 02/08/2023]
Abstract
A wide range of ocular diseases can present with serous subretinal fluid in the macula and therefore clinically mimic central serous chorioretinopathy (CSC). In this manuscript, we categorise the diseases and conditions that are part of the differential diagnosis into 12 main pathogenic subgroups: neovascular diseases, vitelliform lesions, inflammatory diseases, ocular tumours, haematological malignancies, paraneoplastic syndromes, genetic diseases, ocular developmental anomalies, medication-related conditions and toxicity-related diseases, rhegmatogenous retinal detachment and tractional retinal detachment, retinal vascular diseases, and miscellaneous diseases. In addition, we describe 2 new clinical pictures associated with macular subretinal fluid accumulation, namely serous maculopathy with absence of retinal pigment epithelium (SMARPE) and serous maculopathy due to aspecific choroidopathy (SMACH). Differentiating between these various diseases and CSC can be challenging, and obtaining the correct diagnosis can have immediate therapeutic and prognostic consequences. Here, we describe the key differential diagnostic features of each disease within this clinical spectrum, including representative case examples. Moreover, we discuss the pathogenesis of each disease in order to facilitate the differentiation from typical CSC.
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Affiliation(s)
- Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
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39
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Boukari M, Braham IZ, Kaouel H, Anane M, Ammous I, Zhioua R. Bilateral diffuse uveal melanocytic proliferation: Report of a rare Ocular Paraneoplastic Syndrome. LA TUNISIE MEDICALE 2021; 99:298-301. [PMID: 33899202 PMCID: PMC8715793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
Bilateral diffuse uveal melanocytic proliferation is a rare paraneoplastic disorder where bilateral blindness is caused by uveal thickening, serous retinal detachment, and rapid cataract formation. Several different malignancies have been associated with bilateral diffuse uveal melanocytic proliferation, but ovarian carcinoma in women and lung and pancreatic carcinoma in men are the most common. The underlying mechanism is thought to be related to a an endogenous factor wich regulates the proliferation of uveal melanocytes. We present the case of a 75-year-old man with bilateral diffuse uveal melanocytic proliferation secondary to pulmonary adenocarcinoma.
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40
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Guo J, Tang W, Liu W, Zhou M, Chang Q, Jiang C, Xu G, Wang W, Chen Q. A case report of ultrasonographic findings in bilateral diffuse Uveal melanocytic proliferation. BMC Ophthalmol 2020; 20:476. [PMID: 33276763 PMCID: PMC7716585 DOI: 10.1186/s12886-020-01720-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
Background To report undescribed characteristics of patients with bilateral diffuse uveal melanocytic proliferation (BDUMP) on ultrasound biomicroscopy (UBM) and high-frequency B-scan ultrasonography. Case presentation Two of four participants presented with worsening bilateral vision after previously diagnosed primary pulmonary or ovarian carcinoma. The other two patients were diagnosed with lung carcinoma after presentation with BDUMP. All patients had ciliary body nevi-like lesion in combination with iris or ciliary body cysts, and uveal thickening on UBM. Focally elevated choroidal nevi-like lesion and exudative retinal detachment with choroidal thickening were detected with B-scan ultrasonography. Conclusions Our case series demonstrates the uveal characteristics of patients with BDUMP based on high-frequency B-scan ultrasonography and UBM. Ultrasonographic findings are crucial in the diagnosis of BDUMP because it is occult in nature.
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Affiliation(s)
- Jingli Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenyi Tang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wei Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China. .,NHC Key Laboratory of myopia (Fudan University), Shanghai, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
| | - Min Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qing Chang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Chunhui Jiang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenji Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of myopia (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qian Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China. .,NHC Key Laboratory of myopia (Fudan University), Shanghai, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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41
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Benson MD, Rubin U, Cheema M, MacDonald IM, Tennant MT, Hinz BJ, Somani R. Diffuse Pigmented Lesions in the Outer Retina: An Unusual Fundus Appearance. JOURNAL OF VITREORETINAL DISEASES 2020; 4:243-247. [PMID: 37007451 PMCID: PMC9982251 DOI: 10.1177/2474126419873547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This report describes and provides a differential diagnosis for a patient with unusual bilateral retinal pigmented lesions. Methods: A 40-year-old woman was found to have multiple flat, gray lesions scattered across her fundi, becoming larger and more confluent toward the periphery. There were small drusenlike deposits in her foveae. The hyperpigmented lesions demonstrated hypoautofluorescence with thickening of the retinal pigment epithelium and disruption of the overlying layers on optical coherence tomography (OCT). Full-field electroretinography revealed generalized reduced a- and b-wave amplitudes. Results: Chest x-ray, breast ultrasound, mammography, and pelvic ultrasound findings were negative for malignant etiologic factors. Panel testing results for hereditary retinal dystrophy were negative. Conclusions: Although the clinical and OCT appearance of the lesions is similar to congenital grouped pigmentation, the symmetric and bilateral nature of ocular findings coupled with electroretinographic changes suggest a possible retinal dystrophy. This case adds to the phenotypic diversity of pigmented fundus lesions.
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Affiliation(s)
- Matthew D. Benson
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Uriel Rubin
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Marvi Cheema
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Ian M. MacDonald
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew T.S. Tennant
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Brad J. Hinz
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Rizwan Somani
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
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42
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Luo M, Chen Z, Luo Y, Zhao L, Dai R, Zhong Y. Diagnosis of bilateral diffuse uveal melanocytic proliferation unveils primary gastric adenocarcinoma: a case report. BMC Ophthalmol 2020; 20:113. [PMID: 32192441 PMCID: PMC7082900 DOI: 10.1186/s12886-020-01376-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/09/2020] [Indexed: 12/01/2022] Open
Abstract
Background Bilateral diffuse uveal melanocytic proliferation (BDUMP) is an extremely rare paraneoplastic syndrome, with most cases reported as secondary to female urogenital and male lung malignancies. We reported this case of BDUMP patient whose primary malignancy was gastric adenocarcinoma verified with gastroscopy and subsequent pathological test. Case presentation A patient complaining blurred vision was suspected of bilateral diffuse uveal melanocytic proliferation (BDUMP), due to bilateral round oval patches at the posterior pole and cardinal signs in retinal angiography. Malignancy screening was suggested, and pathological report from gastroscopy confirmed the primary lesion as gastric adenocarcinoma. The patient chose palliative care due to late stage and unresectable nature of the malignancy. Conclusions Identifying BDUMP warrants further investigation of a primary malignancy. Our case provided evidence for the link between gastric adenocarcinoma and BDUMP.
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Affiliation(s)
- Mingyue Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Lab of Ocular Fundus Disease, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhe Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Lab of Ocular Fundus Disease, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yaping Luo
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lin Zhao
- Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Rongping Dai
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Key Lab of Ocular Fundus Disease, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Lab of Ocular Fundus Disease, Chinese Academy of Medical Sciences, Beijing, 100730, China
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43
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Leskov I, Lyon AT, Jampol LM. Diffuse Uveal Melanocytic Proliferation With Primary Vitreoretinal Lymphoma. JAMA Ophthalmol 2020; 137:834-837. [PMID: 31046111 DOI: 10.1001/jamaophthalmol.2019.0905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Bilateral diffuse uveal melanocytic proliferation is a rare sign of several systemic malignant neoplasms. Observations A patient presenting with uveal melanocytic proliferation underwent a detailed physical examination and extensive imaging. No systemic malignant neoplasm was found. Chorioretinal biopsy was performed, and its immunohistochemical results revealed the presence of primary vitreoretinal lymphoma. Conclusions and Relevance This patient's results suggest that diffuse uveal melanocytic proliferation may be associated not just with systemic malignant disease, but also with primary intraocular tumors, in this case a primary vitreoretinal lymphoma.
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Affiliation(s)
- Ilya Leskov
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Ophthalmology, SUNY (State University of New York) Downstate Medical Center, Brooklyn
| | - Alice T Lyon
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lee M Jampol
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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44
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Campos Polo R, García Guisado D, Rubio Sánchez C, Bueno García P, Márquez Ivacevich NT. Lymphoma and unilateral diffuse uveal melanocytic proliferation: when both conditions co-exist in the eye. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2020; 95:98-102. [PMID: 31767408 DOI: 10.1016/j.oftal.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
The case is presented of a 60 year-old male with decreased visual acuity in his left eye (LE). In the funduscopic examination, pigmentary alterations associated with sub-retinal orange plaques could be observed that, in autofluorescence, manifested as hypoautofluorescent spots. Subsequently, the patient subsequently developed significant vitritis with large white sub-retinal plaques on the posterior pole of his LE, with no alterations in the right eye. The IL-10/IL-6 coefficient was 0.87, and a lesion suggestive of a lymphoma in the frontal lobe could be seen on brain magnetic resonance scan. The patient was diagnosed with primary lymphoma of the central nervous system with ocular involvement of the LE and associated unilateral diffuse uveal melanocytic proliferation of the same eye. Diffuse uveal melanocytic proliferation is a bilateral para-neoplastic process that occurs as a consequence of carcinomatous tumour processes, although it does not always meet these characteristics.
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Affiliation(s)
- R Campos Polo
- Hospital Virgen del Puerto, Plasencia, Cáceres, España.
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45
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O'Day R, Michalova K, Campbell WG. Bilateral Diffuse Uveal Melanocytic Proliferation Associated With Bladder Cancer: A Novel Imaging Finding. Ophthalmic Surg Lasers Imaging Retina 2020; 50:525-528. [PMID: 31415702 DOI: 10.3928/23258160-20190806-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/01/2019] [Indexed: 11/20/2022]
Abstract
The authors report a case of bilateral diffuse uveal melanocytic proliferation associated with transitional cell carcinoma of the bladder. A novel imaging finding on indocyanine green angiography of a "string of sausages" pattern in the large choroidal vessels is described. This occurs in areas of alternating retinal pigment epithelial hypertrophy and destruction, which is likely to be its cause. To the authors' knowledge, it has not been previously described. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:525-528.].
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46
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Jampol LM, Leskov I, Lyon AT. Diffuse Uveal Melanocytic Proliferation With Primary Vitreoretinal Lymphoma-Reply. JAMA Ophthalmol 2019; 137:1466-1467. [PMID: 31647494 DOI: 10.1001/jamaophthalmol.2019.4263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lee M Jampol
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois
| | - Ilya Leskov
- Ophthalmology, State University of New York Downstate Medical School, Brooklyn
| | - Alice T Lyon
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois
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Raval V, Pathengay A, Narayanan R. Bilateral diffuse uveal melanocytic proliferation secondary to thyroid carcinoma. Indian J Ophthalmol 2019; 67:2094-2097. [PMID: 31755473 PMCID: PMC6896546 DOI: 10.4103/ijo.ijo_445_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We present a rare case of a bilateral diffuse uveal melanocytic proliferation (BDUMP), which occurred secondary to recurrence of carcinoma of thyroid in a 79-year-old gentleman who was initially misdiagnosed to have age related macular degeneration and/or chronic central serous chorioretinopathy. In spite of being treated with anti-VEGF injection and photodynamic therapy there was progressive loss of vision. Multimodal imaging like autoflourescence, infrared imaging, fluorescein angiography, indocyanine angiography, and OCT angiography helped us in clinching the final diagnosis.
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Affiliation(s)
- Vishal Raval
- Retina and Vitreous Services, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Avinash Pathengay
- Retina and Vitreous Services, L V Prasad Eye Institute, Vishakapatnam, Andhra Pradesh, India
| | - Raja Narayanan
- Retina and Vitreous Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Tanaka M, Kamoi K, Nagaoka N, Ishida T, Karube H, Takase H, Ohno-Matsui K. Bilateral diffuse retinal pigment epithelium proliferation induced by choroidal inflammation: A case report. Medicine (Baltimore) 2019; 98:e18152. [PMID: 31764858 PMCID: PMC6882585 DOI: 10.1097/md.0000000000018152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
RATIONALE Proliferation of retinal pigment epithelium (RPE) is typically observed in limited ocular disorders, in connection with the local mechanism of RPE proliferation-mediated wound repair. Bilateral and diffuse type RPE proliferation is considered to be associated with paraneoplastic syndromes, such as a bilateral diffuse uveal melanocytic proliferation. However, other reported diseases that induce bilateral diffuse RPE proliferation are quite rare, especially for patients who are considered to have a non-malignant status. PATIENT CONCERNS The bilateral eyes of a 47-year-old woman with bilateral ocular inflammation, presented united multiple small to medium white retinal lesions during the disease progress. DIAGNOSES Optical coherence tomography showed scattered serous retinal detachments, choroidal folds, choroidal thickening and diffuse RPE proliferation. As autofluorescence and angiography showed a "giraffe pattern", bilateral diffuse uveal melanocytic proliferation was suspected. However, systemic investigations identified no malignancy. In consideration of the above findings, choroidal inflammation was thought to be the major cause of this condition. INTERVENTIONS The patient was administered intensive systemic steroids. Over the next 2 months, the amount of steroid was tapered off. OUTCOMES After administration, the bilateral diffuse RPE proliferation settled down. During the 2-year follow-up, there was no recurrence of ocular inflammation and diffuse RPE proliferation, or any other malignancy found. LESSONS This finding demonstrates that bilateral diffuse RPE proliferation can be generated as a secondary phenomenon of choroidal inflammation in patients with a non-malignant status.
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Affiliation(s)
- Miyuki Tanaka
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
- Department of Ophthalmology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Natsuko Nagaoka
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tomoka Ishida
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Hisako Karube
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Hiroshi Takase
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University
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Touhami S, Audo I, Terrada C, Gaudric A, LeHoang P, Touitou V, Bodaghi B. Neoplasia and intraocular inflammation: From masquerade syndromes to immunotherapy-induced uveitis. Prog Retin Eye Res 2019; 72:100761. [DOI: 10.1016/j.preteyeres.2019.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/16/2019] [Accepted: 05/01/2019] [Indexed: 12/18/2022]
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Kawali AA, Bavaharan B, Mahendradas P. A Lava Lake on Multicolor Imaging of Bilateral Diffuse Uveal Melanocytic Proliferation. JAMA Ophthalmol 2019; 137:e185065. [PMID: 31070686 DOI: 10.1001/jamaophthalmol.2018.5065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ankush Ashok Kawali
- Uveitis and Ocular Immunology Department, Narayana Nethralaya Eye Hospital, Bangalore, Karnataka, India
| | - Bharathi Bavaharan
- Vitreoretina Department, Narayana Nethralaya Eye Hostpital, Bangalore, Karnataka, India
| | - Padmamalini Mahendradas
- Uveitis and Ocular Immunology Department, Narayana Nethralaya Eye Hospital, Bangalore, Karnataka, India
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