Triple Therapy with Rituximab, IVIg and Intravitreal Corticosteroids for Melanoma-associated Retinopathy (MAR): TTRIIC does the trick.
Triple Therapy with Rituximab, IVIg and Intravitreal Corticosteroids for Melanoma-associated Retinopathy (MAR): TTRIIC does the trick.
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利妥昔单抗、IVIg 和玻璃体内皮质类固醇三联疗法治疗黑色素瘤相关视网膜病变 (MAR)：TTRIIC 有效。
DOI：
10.1097/icb.0000000000001081
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发表时间：
2020
影响因子：
--
通讯作者：
Daniels,AnthonyB
中科院分区：
文献类型：
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作者：
Hamdan,SaifA;Breazzano,MarkP;Daniels,AnthonyB
目的：黑色素瘤相关视网膜病变对目前可用的治疗反应不佳，尽管治疗，视觉功能持续慢性下降仍是常态。本报告的目的是描述黑色素瘤相关视网膜病变患者对利妥昔单抗、静脉注射免疫球蛋白和玻璃体内皮质类固醇三联治疗方案的良好反应。方法：单介入病例报告描述黑素瘤相关视网膜病变的管理和患者对这种治疗的反应。通过连续视力、眼底检查、Goldmann视野和视网膜电图监测视网膜功能。结果：一名65岁男性，新发色盲，视力下降，双眼色盲，最近诊断为IIIB期黑色素瘤，最初采用局部广泛切除和辅助干扰素治疗。他被诊断患有黑色素瘤相关的视网膜病变，在使用干扰素治疗黑色素瘤的过程中病情开始恶化。我们开始了利妥昔单抗、静脉注射免疫球蛋白和玻璃体内皮质类固醇的三联治疗，这导致视网膜电图功能完全恢复，双眼视力恢复到20/20。结论：这是首例利妥昔单抗、静脉注射免疫球蛋白和玻璃体内类固醇三联疗法成功治疗黑色素瘤相关视网膜病变的报道，其视力、症状、视野和视网膜电图均有改善。
Purpose:Melanoma-associated retinopathy responds poorly to currently-available therapies, with continued chronic decline in visual function being the norm, despite treatment. The purpose of this report is to describe the excellent response of a patient with melanoma-associated retinopathy to a triple therapy regimen of rituximab, intravenous immunoglobulin, and intravitreal corticosteroids.Methods:Single interventional case report describing management of melanoma-associated retinopathy and the patient's response to this treatment. Retinal function was monitored by serial visual acuity, fundus exams, Goldmann visual fields, and electroretinography.Results:A 65-year old man presented with new onset photopsia, decrease visual acuity and nyctalopia in both eyes in the setting of recently-diagnosed Stage IIIB melanoma, initially treated with wide local excision and adjuvant interferon. He was diagnosed with melanoma-associated retinopathy that initially worsened during his course of interferon for treatment of the melanoma. We initiated triple therapy with rituximab, intravenous immunoglobulin, and intravitreal corticosteroids, and this resulted in full return of electroretinography function and resumption of 20/20 visual acuity in both eyes.Conclusion:This is the first reported case of the utility of triple therapy with rituximab, intravenous immunoglobulin, and intravitreal steroids for successful management of melanoma-associated retinopathy as demonstrated by improvement in acuity, symptoms, visual fields, and electroretinography.