Bilateral Diffuse Uveal Melanocytic Proliferation in the Setting of Ovarian Cancer

Abstract

Purpose: To describe a case of bilateral diffuse uveal melanocytic proliferation in the setting of metastatic ovarian cancer. Methods: A single case was analyzed and a literature review of treatment efficacy performed. Results: A 64-year-old woman presented to ophthalmology in July 2022 for evaluation of blurred vision in the setting of ovarian cancer and a possible reaction to chemotherapy. A comprehensive workup led to the diagnosis of bilateral diffuse uveal melanocytic proliferation. Treatment to potentially preserve the patient’s vision comprised a sub-Tenon triamcinolone injection and plasmapheresis. Conclusions: Plasmapheresis did not improve the visual acuity (VA) in the patient’s right eye; however, 6 months after the last treatment, the VA in the left eye improved from 20/50 to 20/30, corresponding to a decrease in macular edema. Given the rarity of bilateral diffuse uveal melanocytic proliferation, its uncertain pathogenesis, and its varied responses to treatment, it is imperative to establish a diagnostic management and treatment algorithm to improve visual outcomes.