Acute Angle Closure Precipitated by Hemorrhage and Necrosis of a Large Uveal Melanoma in the Setting of Systemic Immunomodulatory Therapy

Chau M Pham; Krishna Kalyam; Bradley T Smith; Justin Floyd; John B Holds

doi:10.1159/000460255

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Acute Angle Closure Precipitated by Hemorrhage and Necrosis of a Large Uveal Melanoma in the Setting of Systemic Immunomodulatory Therapy

Journal article

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Acute Angle Closure Precipitated by Hemorrhage and Necrosis of a Large Uveal Melanoma in the Setting of Systemic Immunomodulatory Therapy

Chau M Pham, Krishna Kalyam, Bradley T Smith, Justin Floyd and John B Holds

Ocular oncology and pathology, Vol.3(4), pp.254-258

11/2017

DOI: 10.1159/000460255

PMCID: PMC5757549

PMID: 29344476

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Abstract

Management of nonmetastatic uveal melanoma has been well studied and a large body of work has been published by the Collaborative Ocular Melanoma Study (amongst many others). Management of uveal melanoma that is found to be metastatic upon initial diagnosis, however, is less well defined. We report an interesting case of acute angle closure caused by necrosis and hemorrhage into a large uveal melanoma occurring shortly after initiation of immunomodulatory therapy with ipilimumab and nivolumab for metastatic disease. The use of these immunomodulatory agents in the setting of metastatic uveal melanoma is not well studied, and our case illustrates the importance of interdisciplinary communication in order to best decide the timing of surgical and systemic medical management to optimize outcomes and minimize morbidity.

Uveal melanoma

Acute angle closure

Immunomodulatory therapy

Tumor necrosis

Hemorrhage

Novel Insights from Clinical Practice

Details

Title: Subtitle: Acute Angle Closure Precipitated by Hemorrhage and Necrosis of a Large Uveal Melanoma in the Setting of Systemic Immunomodulatory Therapy
Creators: Chau M Pham - Department of Ophthalmology and Visual Sciences, Washington University School of Medicine
Krishna Kalyam - Department of Ophthalmology and Visual Sciences, Washington University School of Medicine
Bradley T Smith - The Retina Institute, St. Louis, MO
Justin Floyd - Cancer Care Specialists of Illinois, Swansea, IL
John B Holds - Ophthalmic Plastic and Cosmetic Surgery Inc., St. Louis, MO, USA
Resource Type: Journal article
Publication Details: Ocular oncology and pathology, Vol.3(4), pp.254-258
DOI: 10.1159/000460255
PMID: 29344476
PMCID: PMC5757549
NLM abbreviation: Ocul Oncol Pathol
ISSN: 2296-4681
eISSN: 2296-4657
Publisher: S. Karger AG
Language: English
Date published: 11/2017
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9984109886402771

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