To present a case of bilateral visual acuity decrease in 82 y.o. female with a cancer history.
Methods
An 82-year-old woman was referred due to bilateral visual loss treated with 3 ranibizumab injections in both eyes, for presumed choroidal neovascularization (CNV) without improvement. Her past ocular history entailed cataract surgery for rapidly progressive cataract in the LE. Past medical history (PMH), was significant for colon cancer treated with surgery and chemotherapy 15 years ago. On the first examination in our clinic the patient’s best corrected visual acuity (BCVA) was 20/100 OU. Dilated fundus exam disclosed bilateral scattered orange lesions. Fundus view in the RE was compromised due to cataract. OCT exam revealed subretinal fluid in both eyes, thickened RPE with clumps alternating with areas of RPE atrophy and loss of photoreceptors. FAF showed decreased signal corresponding to the RPE destruction and increased signal in the intervening areas, in a giraffe pattern (Figure 3). Her latest fluorescein angiography (FA), after the cataract extraction showed multiple bilateral hyperfluorescent areas at the posterior pole. The constellation of past medical history and ophthalmic imaging findings were compatible with the diagnosis of Bilateral Diffuse Uveal Melanocytic proliferation (BDUMP). The patient was referred to an oncologist for further evaluation.
Results
BDUMP is a bizarre disease in the paraneoplastic spectrum, resulting in painless, severe visual loss.
Conclusion
The management of BDUMP should focus on the systemic carcinoma, as BDUMP is only the tip of the iceberg. The results from corticosteroids, local or systemic, are variable. Prognosis is poor because the patient usually succumbs to the underlying malignancy
Conflict of interest
No
Authors 1
Last name
TOUMANIDOU
Initials of first name(s)
V
Department
University of Thessaly, Department of Ophthalmology, Greece
City
LARISA
Country
Greece
Authors 2
Last name
RIRI
Initials of first name(s)
K
Department
University of Thessaly, Department of Ophthalmology, Greece
City
LARISA
Country
Greece
Authors 3
Last name
LAZARI
Initials of first name(s)
C
Department
University of Thessaly, Department of Ophthalmology, Greece
City
LARISA
Country
Greece
Authors 4
Last name
CHADOULOS
Initials of first name(s)
N
Department
University of Thessaly, Department of Ophthalmology, Greece
City
LARISA
Country
Greece
Authors 5
Last name
ANDROUDI
Initials of first name(s)
S
Department
University of Thessaly, Department of Ophthalmology, Greece
City
LARISA
Country
Faroe Islands
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