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Ophthalmic Images
January 9, 2020

Choroidal Metastasis From Melanoma Treated by Cyberknife Irradiation

Author Affiliations
  • 1Department of Ophthalmology, Croix-Rousse University Hospital, Lyon, France, UMR-CNRS 5510 Matéis, Villeurbane, France
  • 2Department of Ophthalmology, Pasteur II Hospital, Nice, France
  • 3Department of Radiation Therapy, Centre François Baclesse–ARCHADE, Unicaen–Normandie University, Caen, France
JAMA Ophthalmol. 2020;138(1):e190388. doi:10.1001/jamaophthalmol.2019.0388

A 36-year-old woman presented with visual deterioration and headache. Ophthalmologic examination results showed a 5-mm-thick choroidal mass in her right eye. Head and chest computed tomography scans showed brain and lung metastases. A resection of her lung nodule revealed metastatic BRAF V600–mutated melanoma. The patient underwent systemic targeted therapy followed by 6 sessions of Gamma Knife (Elekta) irradiation for her brain metastases. Ocular Cyberknife (Accuray) stereotactic radiotherapy was performed with a macular- and optic nerve–sparing approach. Despite disease progression in the brain, the abnormal thickness resolved in her eye and her visual acuity increased from 20/200 OD to 16/20 OD at 3 months (Figure).