Intravitreal aflibercept combined with transpupillary thermotherapy in the treatment of refractory macular edema due to primary uveal melanoma

Yu-Te Huang; Chun-Ju Lin; Ning-Yi Hsia; Chun-Ting Lai; Henry Bair; Yi-Yu Tsai

doi:10.4103/tjo.tjo_44_21

Intravitreal aflibercept combined with transpupillary thermotherapy in the treatment of refractory macular edema due to primary uveal melanoma

Taiwan J Ophthalmol. 2022 Jan 7;12(4):482-486. doi: 10.4103/tjo.tjo_44_21. eCollection 2022 Oct-Dec.

Authors

Yu-Te Huang¹, Chun-Ju Lin^{1

2

3}, Ning-Yi Hsia¹, Chun-Ting Lai¹, Henry Bair^{1

4}, Yi-Yu Tsai^{1

2

3}

Affiliations

¹ Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.
² School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
³ Department of Optometry, Asia University, Taichung, Taiwan.
⁴ Stanford University School of Medicine, Stanford, California, USA.

Abstract

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.

Keywords: Aflibercept; cystoid macula edema; multimodal image; subretinal fluid; uveal melanoma.

Publication types

Case Reports