The Impact of Intravitreal Bevacizumab Therapy on Choroidal Melanoma

Purpose To describe the clinical course and ancillary findings of 3 patients with choroidal melanoma who inadvertently received multiple intravitreal injections of bevacizumab for a presumed diagnosis of choroidal neovascular membrane. Design Observational case series. Methods Three patients with choroidal melanomas who received a series of monthly intravitreal injections of bevacizumab for presumed choroidal neovascularization were evaluated. Clinical, ultrasonographic, and angiographic findings are presented. Histopathologic features are correlated with clinical features in 2 patients who underwent enucleation. Results Lack of benefit in halting tumor progression was observed in all 3 cases. In 2 cases treated with enucleation, there was evidence of bevacizumab-induced gliotic/fibrotic retinal changes. Conclusions We present 3 cases of choroidal melanomas that showed progression while patients received multiple intravitreal injections of bevacizumab. The use of the drug led to the formation of a gliotic/fibrotic membrane that resulted in masking of the underlying tumor and consequently delayed the correct diagnosis.