A man in his 40s with a history of cutaneous malignant melanoma on his thigh, treated with complete excision 4 years earlier, presented to the ophthalmology department with sudden onset of blurred vision in his left eye. On biomicroscopy, a suspicious lesion was documented (Figure). A presumed diagnosis of cutaneous melanoma metastasis was suggested by the patient’s history and ultrasound biomicroscopy, revealing a solid lesion with heterogeneous internal reflectivity. Positron emission tomography–computed tomography confirmed metastases affecting the skin, lower limbs, lymph nodes, lungs, and left iris. After multidisciplinary consultation, systemic treatment with a combined regimen of oral BRAF and MEK inhibitors (vemurafenib and cobimetinib) was instituted. Complete regression of the iris lesions was observed after 3 months. The patient is currently receiving oral targeted therapy and close follow-up. New therapeutic strategies, such as MAPK (mitogen-activated protein kinase) pathway inhibitors, have changed the management and improved survival of patients with metastatic melanoma.1
Fonseca C, Fernandes J, Proença R. Regression of Iris Metastasis After Systemic Treatment With Melanoma-Targeted Therapy. JAMA Ophthalmol. 2017;135(2):e165462. doi:10.1001/jamaophthalmol.2016.5462
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