Failure of intravitreal bevacizumab in the treatment of choroidal metastasis

Abstract

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.

Effective Treatment with Intravitreal Injection of Bevacizumab for Exudative Retinal Detachment Secondary to Choroidal Metastasis of Non-Small Cell Lung Carcinoma

“…In 2 cases of SCLC, intravitreal bevacizumab was not effective, but it improved choroidal metastasis in 7 of 9 NSCLC cases. Intravitreal bevacizumab is a promising alternative to ocular radiation, especially for treatment of non-small non-squamous lung cancer [ 1 , 10 , 11 ].…”

“…Additionally, if it is used with intravitreal injection, high-dose bevacizumab can cure the metastasis lesions [ 6 , 9 ]. To date, 9 reports involving 11 cases have been published on intravitreal bevacizumab as a primary treatment modality for choroidal metastasis from lung cancer [ 1 , 10 , 11 ]. Herein, we report a case of effective treatment with intravitreal injection of Bevacizumab for exudative retinal detachment secondary to choroidal metastasis of non-small cell carcinoma (NSCLC).…”

Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review

“…Papers such as those published by Ma et al, Ha et al, Khawaja et al, and Lin et al showed unilateral single choroidal mass in reports of colorectal adenocarcinoma [5,13,19,32]. Moreover, Maudgil et al described two eyes with a single choroidal mass in patients with diagnosis of adenocarcinoma of the cecum, while Ward et al reported single bilateral choroidal masses in a patient with presumed colon cancer [33,34]. Similar to most previous publications, our patient presented with a unilateral hyperreflective and hyperechogenic choroidal mass in the inferior temporal arcade.…”

Response to: ‘Comment on The Eye Phone Study: reliability and accuracy of assessing Snellen visual acuity using smartphone technology’

“…We read with interest the article published in your journal 'Failure of intravitreal bevacizumab in the treatment of choroidal metastasis'. 1 We agree that intravitreal bevacizumab as the primary treatment of choroidal metastases might not always be efficacious in controlling the disease and should not delay treatment that is more radical.…”