Intravitreal aflibercept combined with transpupillary thermotherapy in the treatment of refractory macular edema due to primary uveal melanoma
Yu-Te Huang1, Chun-Ju Lin2, Ning-Yi Hsia1, Chun-Ting Lai1, Henry Bair3, Yi-Yu Tsai2
1 Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
2 Department of Ophthalmology, China Medical University Hospital, China Medical University; School of Medicine, College of Medicine, China Medical University; Department of Optometry, Asia University, Taichung, Taiwan
3 Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan; Stanford University School of Medicine, Stanford, California, USA
Department of Ophthalmology, 2 Yuh-Der Road, Taichung 40447
Source of Support: None, Conflict of Interest: None
We reported a 74 year old Asian female with a uveal tumor with subretinal fluid (SRF) and cystoid macula edema. Since she declined biopsy, multimodal imaging study was performed, including fundus photography, ultrasonography, optical coherence tomography, fluorescein angiography, and magnetic resonance imaging. Uveal melanoma was diagnosed. However, despite aggressive treatment with TTT and three adjuvant intravitreal bevacizumab doses, SRF, and cystoid macula edema were persistent. Therefore, aflibercept was administered, resulting in anatomical and functional improvement within 1 month, which lasted for 12 months. Aflibercept offered great efficacy in improving refractory macular edema in this case of primary uveal melanoma. Multimodal imaging can provide us with more diagnostic clues in differentiating the nature of intraocular tumors.