Recovery of visual function in patient with melanoma-associated retinopathy treated with surgical resection and interferon-beta

We report on a 33-year-old woman who was treated for a cutaneous malignant melanoma on a left finger by surgical resection and chemotherapy including local injections of interferon-beta in 2007. In March 2009, the melanoma had metastasized to her left hand, and she underwent metastasectomy and monthly local injections of interferon-beta. She developed shimmering vision, photopsia, blurred vision, and night blindness in her left eye in April 2009 and visited our clinic. At our initial examination, her best-corrected visual acuity was 1.5 OD and 1.2 OS, and ophthalmoscopy showed that the retina appeared normal in both eyes. However, there was a mild narrowing of retinal arteries in the left eye. Humphrey field analyzer (HFA) showed a reduction in retinal sensitivity within the central 30 degrees of the left eye. The maximum combined response of the full-field electroretinogram (ERG) had a normal waveform in the right eye and a negative waveform in the left eye. Immunocytochemical tests showed antibodies against retinal bipolar cells, which confirmed the diagnosis of melanoma-associated retinopathy (MAR). The metastatic melanoma was successfully treated. Seventeen months after her first visit, her visual acuity was 1.5 OD and 1.2 OS, and HFA showed normal retinal sensitivity in both eyes. The full-field ERGs were also normal in both eyes. Although several therapeutic modalities have been proposed for MAR, surgical resection with local injections of interferon-beta should be considered as a treatment option for MAR patients.