Regression of a Subfoveal Choroidal Metastasis of Colorectal Carcinoma After Intravitreous Bevacizumab Treatment

Emerging Treatments for Choroidal Metastases

“…Four case reports have described the use of intravitreal bevacizumab in patients with breast carcinoma, colon adenocarcinoma, and NSCLC found to have new choroidal lesions despite systemic therapy. 3,32,36,70 In all four case reports, lesions regressed and retinal detachments resolved after one injection of bevacizumab.…”

“…3,32 In the first case of a patient with choroidal metastasis from colorectal cancer, the initial fluorescein angiogram showed that the lesion contained numerous subretinal vascular channels that filled unevenly in the early frames and leaked profusely in late frames. One month after intravitreal injection of 1.25 mg bevacizumab, the angiogram showed a 50% reduction in lesion size and significantly less leakage in the late frames.…”

“…One month after a second injection, there was no leakage whatsoever. 32 In the second study of a patient with metastatic breast cancer, initial fluorescein angiogram showed prominent leakage in the region of the choroidal metastasis with involvement of the fovea. Three weeks after injection of 4 mg bevacizumab, the angiogram showed decreased lesion size and reduced leakage in the late phases.…”

Choroidal Metastasis of Non-Small Cell Lung Cancer That Responded to Gefitinib

“…Only one-third of patients with choroidal metastasis have the primary tumor site identified at the time of diagnosis [1]. The two major primary sites are the breast and lung, and lung cancer accounts for approximately 30% of choroidal metastasis [2]. Visual symptoms may be the first manifestation of systemic metastases.…”

“…In general, systemic chemotherapy alone is effective if the original tumor is susceptible to the cytotoxic agents. Recent progress in molecular targeted drugs has demonstrated favorable outcome for ocular tumors due to their prompt and high response rate [1, 2]. Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKi) is also expected to be a promising treatment for ocular metastasis of non-small cell lung cancer (NSCLC) harboring an EGFR mutation, although little information has been provided.…”