Background Metastasis to choroid is the most common intraocular malignancy, arising most frequently from carcinoma of breast in women and lung in men. Recent case reports have described successful use of intravitreal bevacizumab to achieve local control of such tumours. Materials and methods Five cases of choroidal metastases from varying primaries: breast, lung, and colon were treated with intravitreal bevacizumab, and tumour response observed and documented with serial photographs and B-scans. Results Four of the five tumours were seen to progress despite intravitreal bevacizumab treatment. Conclusions Intravitreal bevacizumab as the primary treatment of choroidal metastases is not recommended and should not delay more effective alternative treatments.

AimsTo investigate the success and recurrence rates and visual outcomes in a large case series of amelanotic posterior choroidal melanomas treated by means of primary photodynamic therapy (PDT) with verteporfin.MethodsRetrospective case series from a single specialist ocular oncology centre. All patients had a clinical diagnosis of choroidal melanoma and were selected for PDT based on tumour characteristics. Included patients had at least 24 months of follow-up from initiation of treatment and all but one had not received treatment prior to PDT.Results69 patients were included. Mean tumour thickness was 1.9 mm (range 0.5–4.4), while the mean basal diameter was 6.9 mm (range 2.4–11.0). Included lesions were stage cT1a (n=66) or cT2a (n=3). The mean duration of follow-up from treatment initiation was 57 months (range 24–116 months). Seven lesions (10%) failed to respond to PDT. 10 patients (16%) experienced recurrence during follow-up. Overall success rate in this series was 75% (n=52). 83% of successfully treated patients (n=43) maintained or gained vision by final follow-up. Visual outcomes were significantly better in those patients who received PDT therapy alone in comparison to those who needed other treatments for their melanoma (Fisher’s exact test, p=0.004). Unfortunately, one patient (1.4%) in the series developed systemic metastases and died.ConclusionSelected amelanotic posterior uveal melanomas may be successfully treated with PDT with retention of good vision in the majority of cases, maintained with a mean of 57 months (minimum of 24 months) of follow-up.

No abstract

No abstract

Purpose: Sympathetic ophthalmia (SO) is a rare panuveitis after trauma to one eye. We present a case of SO after 23-gauge transconjunctival vitrectomy, including optical coherence tomography evidence of response to treatment. To our knowledge, this is the first SO case report to include spectral domain optical coherence tomography images of Dalen-Fuchs nodules.Methods: Observational case report of a case of SO after two pars plana vitrectomies in the fellow eye.Results: A 67-year-old woman who had an operation for her pseudophakic left eye for a macula-off retinal detachment. She had two surgeries and later on had a total retinal detachment with vision of no perception of light. Eighteen months later, she presented back with a panuveitis with vitritis in her other eye and a visual acuity of 6/18. Dalen-Fuchs denoting SO was found. Treatment was commenced, and multimodal imaging was performed.Conclusion: Sympathetic ophthalmia is a known complication after vitrectomy. Optical coherence tomography can be invaluable in monitoring diagnosis and progression of Dalen-Fuchs nodules.