Melanoma-Associated Retinopathy versus Abnormal Retinal Function due to Interferon-α/Isotretinoin Therapy in Cutaneous Malignant Melanoma

Abstract

Purpose: To analyze whether an abnormal retinal function in patients with a cutaneous malignant melanoma was due to paraneoplastic retinopathy or due to isotretinoin or interferon-α. Methods: We studied 15 patients with malignant melanoma in stage IIa and IIb who are all participants in a randomized, multicentered, double-blind placebo-controlled clinical trial comparing interferon-α/isotretinoin versus interferon-α/placebo performed by the Department of Dermatology, University of Graz. Our assessment included a full ophthalmic history and examination, electrophysiological testing (ERG, EOG), dark adaption, color vision and visual field testing. Results: The most prevalent ocular symptom patients complained about was ocular dryness (8 patients). Electrophysiological as well as psychophysical testings showed no abnormalities in 12 patients. In 1 patient the therapy was stopped because of electrophysiological and psychophysiological pathology. This patient suffered from severe reduction of night vision and visual disturbances. Another patient had had night blindness since childhood which remained stable. Conclusions: We postulate that in 1 of 15 patients, visual complaints are caused with a high probability by melanoma-associated retinopathy although, in the literature, isotretinoin is described to show similar effects on retinal function.

Melanoma-associated retinopathy: high frequency of subclinical findings in patients with melanoma

“…None of the patients had a history of drugs known to influence visual function. Patients who received interferon‐α showed no signs of interferon‐associated retinopathy 18 . None had any of the ophthalmological changes associated with diabetes mellitus, arterial hypertonia or glaucoma.…”

Central and Paracentral Visual Field Defects and Driving Abilities

“…Interferon has been associated with VF loss and transient monocular blindness [36, 49, 144, 160, 179]. Recovery after stopping the drug has been reported [121].…”

Corticosteroid Treatment for Melanoma-Associated Retinopathy

“…16 Recently, interferon ␣ therapy has been associated with ocular adverse effects, including dryness and retinopathy. [17][18][19] Their occurrence is correlated with high concentrations of inter- Less frequently, visual loss may be caused by an autoimmune disorder characterized by a high titer of serum antibodies directed against antigens shared by the tumor cells and neurons in the retina or optic nerve, as seen in MAR.…”