Bilateral diffuse uveal melanocytic proliferation with good clinical response to plasmapheresis and treatment of the primary tumor.

PURPOSE: To report successful treatment of bilateral diffuse uveal melanocytic proliferation. METHODS: Case report of a patient with clinical diagnosis of bilateral diffuse uveal melanocytic proliferation, imaged with fluorescein angiography and spectral domain optical coherence tomography, and with follow-up data after treatment with plasmapheresis, radiation, and chemotherapy. RESULTS: A 67-year-old white man presented with a history of bilateral rapidly declining vision. The ophthalmoscopic examination, fluorescein angiography, and optical coherence tomography showed in both eyes an exudative retinal detachment and subretinal lesions highly suggestive for bilateral diffuse uveal melanocytic proliferation. Further investigation demonstrated a large cell lung carcinoma. Subsequently, the patient was treated with plasmapheresis, radiation, and chemotherapy. In a few weeks, the exudative retinal detachments resolved with gain of vision, and the retina remained flat during the 5-month follow-up. CONCLUSION: Plasmapheresis and treatment of the primary tumor are valuable treatment options for visually impaired patients with bilateral diffuse uveal melanocytic proliferation.