Metastatic Tumors to the Iris in 40 Patients

Shields, Jerry A.; Shields, Carol L.; Kıratlı, Hayyam; Potter, Patrick De

doi:10.1016/s0002-9394(14)71227-9

Cited by 169 publications

(124 citation statements)

References 33 publications

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“…The majority of published cases are confined to single case reports. To date, the largest study in the literature was published by Shields et al, 265 who in a study of 512 patients with uveal metastases, found iris involvement in 40 (7.8%) of cases. The breast (40%) and lung (28%) were the most common location for the primary tumour.…”

Section: Eyementioning

confidence: 99%

“…The tumours often appear friable and may liberate cells into the anterior chamber, which can simulate anterior uveitis. 265,269 In addition, iris metastases are capable of invoking a significant inflammatory reaction and as a result may present with a true anterior uveitis. [269][270][271][272][273] Secondary glaucoma is frequently associated with iris metastases occurring in approximately 40% of cases.…”

Section: Eyementioning

confidence: 99%

“…[269][270][271][272][273] Secondary glaucoma is frequently associated with iris metastases occurring in approximately 40% of cases. 265 The diagnosis of an iris metastasis may be relatively straightforward when a patient presents with known carcinomatosis, particularly when there is an associated choroidal deposit. However, when the patient presents with a solitary iris lesion in the absence of a history of malignant disease, the diagnosis may be more problematic.…”

Section: Eyementioning

confidence: 99%

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Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

Rennie

2011

Eye

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Section: Eyementioning

confidence: 99%

Section: Eyementioning

confidence: 99%

Section: Eyementioning

confidence: 99%

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Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

Rennie

2011

Eye

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“…Other symptoms include visual field scotomas, floaters, metamorphopsia and photopsia (22,26). In cases of anterior segment metastasis, a visible mass can be noted and the patient may notice a red eye (27). As mentioned above, most of the uveal lesions involve the choroid, followed by the iris and the ciliary body (9,20).…”

Section: Symptoms and Clinical Characteristicsmentioning

confidence: 99%

“…In cases of choroidal metastasis, the blurring may be secondary to macular involvement or the presence of subretinal fluid that may compromise the fovea (9). Moreover, in cases of iris and/or ciliary body lesions, the decreased visual acuity is usually secondary to seeding to the anterior chamber or the development of secondary cataracts as these lesions tend to produce inflammatory signs more often than choroidal lesions (27). Other symptoms include visual field scotomas, floaters, metamorphopsia and photopsia (22,26).…”

Section: Symptoms and Clinical Characteristicsmentioning

confidence: 99%

Uveal metastatic disease: Current and new treatment options (Review)

Giuliari¹,

Sadaka²

2011

Oncol Rep

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Abstract. Choroidal metastasis represents the most common form of intraocular malignancies. It may occur in up to 10% of patients with systemic metastasis with almost half of the patients developing central nervous system disease. The most common primary sites of ocular metastasis are breast cancer in women and lung cancer in men. In most cases, these lesions tend to be asymptomatic and are not evaluated by an ophthalmologist. The diagnosis is generally made by the history of present or prior malignancies and an ophthalmological examination with slit-lamp biomicroscopy and indirect ophthalmoscopy. As with other malignancies, management may vary with each patient. Small tumors, that do not compromise the vision and that have responded previously to systemic treatment, may be closely observed. For larger lesions and for symptomatic ones, external beam radiation offers an excellent alternative to save the eye and stabilize vision. Bevacizumab (Avastin), a potent monoclonal antibody that has also been employed for the treatment of ocular vaso-proliferative diseases, has been used in the treatment of choroidal metastasis and has shown promising results.

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Metastatic Neoplasms in the Optic Disc

Shields¹

2000

Arch Ophthalmol

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Background: Little information is available on metastatic tumors to the optic disc. Objective: To determine the clinical features and prognosis of patients with optic disc metastasis. Design: Retrospective chart review. Results: Of 660 consecutively evaluated patients with intraocular metastasis, 30 (4.5%) (31 eyes) had metastatic cancer to the optic disc; 24 (80%) were women and 6 (20%) were men. Mean age at the time of ocular diagnosis was 55 years. The primary neoplasm was in the breast in 13 patients (43%), in the lung in 8 (27%), in the intestine in 1 (3%), in the kidney in 1 (3%), and in the prostate in 1 (3%); the primary neoplasm was never determined in 6 patients (20%). The optic disc metastasis was unilateral in 29 patients (97%) and bilateral in 1 (3%). Ophthalmoscopically, the disc metastasis appeared as a diffuse enlargement of the optic disc in 26 eyes (84%) and as a distinct nodule in 5 (16%). There was an adjacent juxtapapillary choroidal component to the metastatic disc lesion in 23 eyes (74%), and the optic disc was involved without a retinal or choroidal component in 8 (26%). Other associated findings included some degree of secondary disc edema in all eyes, buried disc blood vessels in 23 (74%), and splinter hemorrhages in 13 (42%). Fine needle aspiration biopsy was useful in establishing the diagnosis in all 5 eyes in which it was performed. Mean survival was 13 months after diagnosis of the disc metastasis. Conclusions: Metastasis to the optic disc accounts for 5% of all intraocular metastases. It can occur as invasion from a juxtapapillary choroidal metastasis or as isolated optic disc metastasis. Breast and lung cancers are the most common primary neoplasms that account for metastasis to the optic disc. The primary site is never determined in 20% of patients. The characteristic clinical features of optic disc metastasis should help differentiate it from other causes of swollen optic disc. Patient prognosis is poor.

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Metastatic Tumors to the Iris in 40 Patients

Cited by 169 publications

References 33 publications

Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

Uveal metastatic disease: Current and new treatment options (Review)

Metastatic Neoplasms in the Optic Disc

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