Retrospective descriptive study on diagnosed patients of choroidal metastases

Abstract

Purpose The most frequent intraocular tumour are metastatic carcinomas. Although it is a rare entity, choroidal involvement is considered the most frequent intraocular malignancy due in part to its abundant vascularization. Although they are often the first manifestation of the tumour, they usually appear late in the course of a tumour disease and are associated with poor prognosis. The most frequent primary origin in the case of women is the breast and in the male the lung. Blurred vision or visual loss is the most common form of presentation. The therapeutic options include systemic treatments and local therapies such as radiotherapy or surgery among others. Methods Retrospective descriptive study conducted in our centre from May 2009 to May 2019 on patients diagnosed with choroidal metastases. We analysed the primary tumour origin, clinic at the beginning, initial presentation of neoplastic disease, therapeutic attitude and median survival. Results Of the 10 patients studied there were four males (40%) and six females (60%). The average age was 63.6 years. The initial presentation clinic was headache in four patients (40%), exophthalmos in two (20%), visual field reduction in one (1%), blurred vision in one (10%), retinal detachment in one (10%) and seizure in one (10%). As a primary source, pulmonary neoplasia was identified in four patients (40%) (two adenocarcinomas, one squamous and one small cell carcinoma), breast cancer in three patients (30%), adenocarcinoma of the pancreas in one patient (10%), papillary carcinoma of thyroid in one (10%) and high‐grade undifferentiated carcinoma in one (10%). Regarding the treatment received, six patients were candidates for palliative chemotherapy, one for radioactive iodine, one patient could not receive any type of treatment for death and two were candidates for local therapy by exantheration. Conclusions The results obtained in our sample are concordant with those found in the literature, obtaining a median survival of 10 months after the diagnosis of choroidal metastases. Choroidal metastases are a rare entity and generally associated with poor survival. The most commonly identified primary origins are carcinomas of the lung and breast. In a significant percentage of cases, choroidal metastases are the initial presentation of an unknown systemic neoplasm.