Abstract
Purpose
This is the first case report where 1.25 mg intravitreal bevacizumab (IVB) correlated with choroidal mass resolution from metastatic
breast cancer given concurrently with chemotherapy demonstrating, at best, disease
stability in other organs.
Study design
Case report.
Methods
Upon confirmation of choroidal, liver and bone metastasis from breast carcinoma, a
72-year-old female received four intravitreal bevacizumab 1.25 mg injections based on the presence of subretinal and intraretinal fluid. Visual outcomes
were analyzed by ophthalmologic evaluation, B-scan, fluorescein angiography, and optical
coherence tomography.
Results
After 3 treatments of 1.25 mg intravitreal bevacizumab, visual acuity improved from 20/125 OD to 20/30 OD. These
results were maintained for 5 months, after which a 4th IVB injection was given to
try to further improve visual outcomes. Following this, complete resolution of the
mass was observed with remaining pigmentary changes and vision improved to 20/25 one
month following this. IVB was administered concurrently to systemic chemotherapy that
demonstrated at best disease stability in metastases in other organs.
Conclusion
In this case 1.25 mg intravitreal bevacizumab proved to be a safe, effective and relatively easy treatment
for choroidal metastasis from breast cancer. An important benefit of intravitreal
bevacizumab therapy for choroidal metastasis is the ease of administration and minimal
time commitment required as compared to other therapies. Further studies should be
conducted to confirm the appropriate dosing and long-term outcomes of intravitreal
bevacizumab to treat choroidal metastasis.
RÉSUMÉ
Objet
Ceci est le premier compte-rendu selon lequel le bevacizumab intravitréen (BIV) de
1,25 mg qui, en relation avec la résolution d’une masse choroïdienne métastatique d׳un
cancer de sein simultanément avec la chimiothérapie, et démontrant, au mieux, la stabilité
de la maladie dans d’autres organes.
Nature
Compte rendu.
Méthodes
Sur confirmation d’une métastase choroïdienne, du foie et des os, dus à un carcinome
mammaire, une femme de 72 ans a reçu quatre injections intravitréennes de bevacizumab
1,25 mg, fondées sur la présence de fluide sous-rétinien et intrarétinien. Les résultats
visuels ont été analysés par évaluation ophtalmologique, B-scan, angiographie à la
fluorescéine et tomographie par cohérence optique.
Résultats
Après 3 traitements de 1,25 mg de bevacizumab intravitréen, l’acuité visuelle s’est améliorée, de 20/125 OD à
20/30 OD. Ces résultats ont été maintenus 5 mois, après quoi une 4e injection de BIV a été administrée pour améliorer davantage les résultats visuels.
Par la suite, la résolution entière de la masse a été observée selon les changements
pigmentaires restants et l’amélioration de la vision à 20/25 le mois suivant. Le BIV
a été administré en même temps que la chimiothérapie systémique, qui avait démontré,
au mieux, la stabilité de la maladie dans les métastases des autres organes.
Conclusion
Dans ce cas, 1,25 mg de bevacizumab intravitréen se sont avérés un traitement sécuritaire, efficace
et relativement facile pour la métastase choroïdienne provenant du cancer du sein.
Un avantage important de la thérapie du bevacizumab intravitréen pour la métastase
choroïdienne est la facilité d’administration et le temps minime requis comparativement
à d’autres thérapies. D’autres études devraient être effectuées pour confirmer la
dose appropriée et les résultats à long terme du bevacizumab intravitréen pour traiter
la métastase choroïdienne.
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Article info
Publication history
Accepted:
June 26,
2014
Received in revised form:
June 18,
2014
Received:
January 16,
2014
Identification
Copyright
© 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
