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목적 : To determine the efficacy of intravitreal bevacizumab for the treatment of choroidal metastasis in terms of achieving regression of tumor and resolution of associated exudative retinal detachment along with improvement in visual acuity.
방법 : A retrospective review of five tumors in five eyes with choroidal metastasis treated with intravitreal bevacizumab was performed. Ophthalmic features included largest tumor basal dimension and thickness, tumor laterality, anteroposterior location of tumor, quadrant location of tumor, and distance of tumor margin to optic disc and fovea. Any ophthalmic findings associated with choroidal tumors such as the presence of subretinal fluid, hemorrhage, and/or Bruch’s membrane rupture were also recorded. During follow-up, BCVA, change in tumor thickness, and change of associated ophthalmic findings such as exudative retinal detachment as revealed by OCT were analyzed.
결과 : The mean patient age at diagnosis of choroidal metastasis was 54 years (median 50, range 49‒67), and the mean time interval between the diagnosis of primary tumor and choroidal metastasis was 6.75 years (median 4.5 years, range 0‒18). The tumors found in eyes were all solitary. The mean tumor basal diameter was 9.69 mm (median 7.87, range 6.24‒13.57) and the mean tumor thickness was 3.75 mm (median 3.21, range 2.88‒6.11). The mean number of injections was 2.6 (median 2.0, range 2‒4), of which one eye received a dosage of 2.5 mg and 4 eyes received a dosage of 1.25 mg bevacizumab. Complete regression of tumor with resolution of associated exudative retinal detachment occurred after an average duration of 2.8 months (median 3, range 2‒3). In all eyes, the tumor mass almost completely regressed. A significant improvement in BCVA was achieved in all eyes (p = 0.043) and no treatment related complications were noted during the mean follow-up duration of 15 months (median 12, range 12‒26).
결론 : Intravitreal bevacizumab can potentially be a promising adjunctive therapeutic option to achieve tumor regression as well as restore visual acuity. It can be considered an option in cases not responding to conventional systemic therapy in isolated choroidal metastasis and in patients refusing to undergo conventional treatments. Further study with more number of patients is warranted in the future.
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