Vitreous Haemorrhage and Retinal Neovascularization Secondary to Peripheral Retinal Ischemia as the Presenting Sign of a Disseminated Melanoma

Ocul Immunol Inflamm. 2024 Jul;32(5):703-706. doi: 10.1080/09273948.2023.2198003. Epub 2023 Apr 18.

Abstract

Purpose: We describe a case of vitreous haemorrhage and retinal neovascularization secondary to peripheral retinal ischemia associated with disseminated melanoma.

Methods: A retrospective case report.

Results: A 48-year-old man presented with vitreous haemorrhage in the right eye, peripheral retinal ischemia, and retinal neovascularization in both eyes. CT and MRI scans were suggestive of disseminated malignancy and an ultrasound-guided biopsy of the abdominal mass confirmed metastatic melanoma. Immune checkpoint inhibitor therapy with ipilimumab/nivolumab was initiated. Regarding his ocular status, the vitreous haemorrhage cleared spontaneously, visual acuity improved to 6/7.5 and the patient underwent bilateral peripheral scatter laser photocoagulation to stabilize the retinopathy. The patient passed away 1 year after the initial presentation.

Conclusion: Our patient presented with melanoma and peripheral retinal ischaemia, leading to retinal neovascularization and vitreous haemorrhage. Therefore, melanoma should be considered as a differential diagnosis when investigating the aetiology of peripheral retinal ischaemia.

Keywords: CNV; MAR; disseminated melanoma; retinal neovascularization; vitreous haemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Fluorescein Angiography
  • Humans
  • Ipilimumab / therapeutic use
  • Ischemia* / diagnosis
  • Ischemia* / etiology
  • Laser Coagulation
  • Magnetic Resonance Imaging
  • Male
  • Melanoma* / complications
  • Melanoma* / diagnosis
  • Middle Aged
  • Retinal Neovascularization* / diagnosis
  • Retinal Neovascularization* / etiology
  • Retinal Vessels / pathology
  • Retrospective Studies
  • Skin Neoplasms / diagnosis
  • Tomography, Optical Coherence
  • Tomography, X-Ray Computed
  • Visual Acuity / physiology
  • Vitreous Hemorrhage* / diagnosis
  • Vitreous Hemorrhage* / etiology

Substances

  • Ipilimumab