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).
Mathis T, Caujolle J, Thariat J. Choroidal Metastasis From Melanoma Treated by Cyberknife Irradiation. JAMA Ophthalmol. 2020;138(1):e190388. doi:10.1001/jamaophthalmol.2019.0388
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