First Author: M.Nunez Izquierdo SPAIN
Co Author(s): M. Mendivil Soto I. Bearan Maria E. Ispizua Mendivil P. Fernandez Avellaneda
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To report a case and show the images of multiple bilateral photoreceptor outer segment impairment in a 44-year-old woman who was diagnosed of metastatic high grade epithelial ovarian cancer and was being treated with intravenous bevacizumab.
As Retinologists, we are very used to diagnose systemic diseases before they happen or to follow them up just through a dilated retinal examination or by analyzing an image (a fluorescein angiography, an OCT…). We have a very special role in the diagnostic of lethal diseases.
Observational case report
We present the case of a 44-year-old woman with past medical history of high grade epithelial ovarian cancer diagnosed in year 2015 with lung, liver and retroperitoneal metastasis. She underwent surgery and intravenous treatment with bevacizumab (12 sessions in total) and poor response was detected. The patient was referred to our Department in year 2016 because she was complaining about visual acuity impairment. Her best corrected visual acuity was 1 in each eye, but she noticed bilateral metamorphopsia in Amsler Grid test. Dilated retinal examination revealed many macular and peripapilllar small (1 mm approximately) round well defined yellow lesions. In OCT those lesions corresponded to photoreceptor outer segment impairment. We also measured a pachychoroid in both eyes. Other tests such as autofluorescence and fluorescein angiography findings were unremarkable. Antirecoverin antibodies were also negative.
We have not found any bibliography about the retina lesions related to ovarian cancer and treatment with intravenous bevacizumab that our patient presented. We made differential diagnosis with cancer associated retinopathy, paraneoplastic viteliform maculopathy, autoinmune retinopathy and retinal toxicity.