Isolated Unilateral Infiltrative Optic Neuropathy in a Patient with Breast Cancer

Abstract

Metastasis to the optic nerve is very rare. We report a case of metastatic breast cancer to the optic nerve head without the involvement of other ocular or orbital structures. The patient, a 39-year-old female who had been previously treated for breast cancer, reported a gradually progressive decrement in visual acuity of the right eye during the past two months. Fundus examination of the affected eye revealed swelling of the optic disc which was infiltrated by a yellowish mass. Further evaluation using optical coherence tomography and fluorescein angiography showed optic disc swelling. Magnetic resonance imaging revealed no pathologic findings. With a diagnosis of unilateral infiltrative optic neuropathy, we referred the patient to an oncologist for further evaluation.

Optic disc and choroidal metastases secondary to breast cancer: A case report

“…Diagnosis of choroidal and/or optic disc metastasis is based on clinical history and fundus examination, though it has greatly benefited from the contribution and the development of modern multimodal imaging techniques. [5][6][7] CFP and IR showed in this case a large yellow subretinal mass located at the macula and extending beyond the temporal vascular arches and nasally to the optic disc. Uncommon papillary lesions were also noted, associated to optic disc edema probably secondary to the local compression of the tumor.…”

“…Diagnosis of choroidal and/or optic disc metastasis is based on clinical history and fundus examination, though it has greatly benefited from the contribution and the development of modern multimodal imaging techniques. 5–7…”

“…They also reported an increased optic nerve sheath diameter on ultrasonography, with an altitudinal defect and blind spot enlargement on visual field test. 7…”

“…They also reported an increased optic nerve sheath diameter on ultrasonography, with an altitudinal defect and blind spot enlargement on visual field test. 7 In the literature, mean survival after diagnosis of disc metastasis is 13 months. 1 Our patient deceased only 6 weeks following the diagnosis of optic disc and choroidal metastases.…”

A ‘never miss’ diagnosis: Ptosis secondary to metastatic breast cancer diagnosed as involutional ptosis and a review of the literature

“…The search phrase ‘breast cancer metastasis to the orbit’, ‘metastatic breast cancer to orbit’, and ‘orbital metastasis from breast cancer’ identified 101 cases. 3…”