Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 500
  • Home
  • Print this page
  • Email this page

   Table of Contents      
LETTER TO THE EDITOR
Year : 2018  |  Volume : 66  |  Issue : 8  |  Page : 1230

Comment on: A rare case of unilateral diffuse melanocytic proliferation


Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication23-Jul-2018

Correspondence Address:
Dr. Mohit Dogra
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_565_18

Rights and Permissions

How to cite this article:
Dogra M, Singh SR, Singh R, Dogra MR. Comment on: A rare case of unilateral diffuse melanocytic proliferation. Indian J Ophthalmol 2018;66:1230

How to cite this URL:
Dogra M, Singh SR, Singh R, Dogra MR. Comment on: A rare case of unilateral diffuse melanocytic proliferation. Indian J Ophthalmol [serial online] 2018 [cited 2020 May 24];66:1230. Available from: http://www.ijo.in/text.asp?2018/66/8/1230/237343



Sir,

We read with great interest the case report by Ayachit et al.[1] describing unilateral presentation of diffuse uveal melanocytic proliferation (DUMP) syndrome. The authors must be complemented on immaculate documentation of this rare case with multimodal imaging.

However, a couple of areas need clarification. Oral tamoxifen was started for this patient with biopsy-proven metastatic breast cancer as the tumor had estrogen and progesterone receptor (PR) positivity. Tamoxifen has been shown to be the treatment of choice for postmenopausal females with PR-positive metastatic breast cancer.[2] How did the primary site respond to chemotherapy? If the tumor reduced in size after chemotherapy, is it not possible that the paraneoplastic syndrome associated with it would also reduce in severity/intensity?

Second, DUMP is a paraneoplastic phenomenon and hence to institute intravitreal bevacizumab (IVB) therapy for this entity defies logic. Furthermore, regression shown by the authors on optical coherence tomography is after 2 months after starting tamoxifen and IVB. The authors site the report by Lin et al., in which the efficacy of IVB for choroidal metastasis due to colon cancer is highlighted.[3] DUMP is distinct from metastasis and occurs due to distant effect of the primary tumor. To ascribe the resolution of subretinal fluid and improvement of visual acuity solely to IVB would be incorrect, especially when it is known that even plasmapheresis/steroids do not work in most cases of DUMP.[4],[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ayachit G, Ayachit A, Joshi S, Vasudevan SV. A rare case of unilateral diffuse melanocytic proliferation. Indian J Ophthalmol 2018;66:588-90.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Bergh J, Jönsson PE, Glimelius B, Nygren P; SBU-group. Swedish Council of Technology Assessment in Health Care. A systematic overview of chemotherapy effects in breast cancer. Acta Oncol 2001;40:253-81.  Back to cited text no. 2
    
3.
Lin CJ, Li KH, Hwang JF, Chen SN. The effect of intravitreal bevacizumab treatment on choroidal metastasis of colon adenocarcinoma – case report. Eye (Lond) 2010;24:1102-3.  Back to cited text no. 3
    
4.
Schelvergem KV, Wirix M, Nijs I, Leys A. Bilateral diffuse uveal melanocytic proliferation with good clinical response to plasmapheresis and treatment of the primary tumor. Retin Cases Brief Rep 2015;9:106-8.  Back to cited text no. 4
    
5.
Moreno TA, Patel SN. Comprehensive review of treatments for bilateral diffuse uveal melanocytic proliferation: A focus on plasmaphereis. Int Ophthalmol Clin 2017;57:177-94.  Back to cited text no. 5
    




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed502    
    Printed0    
    Emailed0    
    PDF Downloaded104    
    Comments [Add]    

Recommend this journal