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Visual improvement in amblyopic eye following treatment-induced vision loss in dominant eye with uveal melanoma
  1. Aldo Vagge1,2,
  2. Carol L Shields3,
  3. Jerry A Shields3,
  4. Renelle Pointdujour-Lim3,
  5. Bruce Schnall1,4
  1. 1 Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  2. 2 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University Eye Clinic, IRCCS Ospedale Policlinico San Martino, Genova, Italy
  3. 3 Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  4. 4 Advocare Schnall Pediatric Ophthalmology, Voorhees, New Jersey, USA
  1. Correspondence to Dr Aldo Vagge, DINOGMI, University Eye Clinic of Genoa, IRCSS Ospedale Policlinico San Martino, Genova, GE, Italy; aldo.vagge{at}gmail.com

Abstract

Objective To determine the frequency and amount of visual improvement in amblyopic eyes of adults following visual loss in the dominant eye resulting from treatment of uveal melanoma.

Methods and analysis Retrospective case series of adult patients with amblyopia and dominant eye visual loss resulting from treatment of uveal melanoma. Review of best-corrected visual acuity (BCVA) in each eye (amblyopia eye vs melanoma eye) at date first seen and over time following treatment of uveal melanoma. BCVA in each eye was graded as improved (>2 logarithm of minimal angle of resolution (logMAR) lines) or unimproved (<2 logMAR lines).

Results Twenty-one patients that met the inclusion criteria. Mean age at presentation was 56 years (range 39–73 years). Following treatment of the uveal melanoma and decline of BCVA in the dominant, the BCVA in the amblyopic eye improved in 11/21 (52%; 95% CI 30% to 74 %) patients. The degree of visual loss in the melanoma eye was to the level of the amblyopic eye or worse in 14 patients. In this group, BCVA improved in the amblyopic eye in 9/14 (64%; 95% CI 35% to 87 %) patients. Of these nine with improved eyes, the mean starting visual acuity was logMAR 0.6 (20/80) with mean improvement of logMAR 0.4 (4 lines±0.13 (range 0.2–0.6). Eight of nine eyes achieved a BCVA of 20/25 (n=3) or 20/20 (n=5).

Conclusion Visual acuity in the amblyopic eye of adults can improve following visual loss in the contralateral dominant eye associated with treatment for uveal melanoma.

  • treatment other
  • vision
  • amblyopia
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Footnotes

  • Presented at Part of this study has been presented at AAPOS 2017 Annual Meeting 2017 in Nashville, Tennessee, USA

  • Contributors AV contributed to the data acquisition and writing of the manuscript. CLS and JAS contributed to the material support. RP-L contributed to the drafting the manuscript. BMS contributed to the design of the study and supervision. AV and BMS contributed to the conception. CLS, JAS and BMS contributed to the critical revision of the manuscript. All authors contributed to the data interpretation.

  • Funding Support provided by Eye Tumor Research Foundation, Philadelphia, Pennsylvania, USA (CLS and JAS). The funders had no role in the design and conduct of the study, in the collection, analysis and interpretation of the data, and in the preparation, review or approval of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Institutional Review Board approval was obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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