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Choroidal Metastasis

  • Greg Bever
  • Armin Afshar
  • Bertil Damato
Chapter
Part of the Retina Atlas book series (RA)

Abstract

Uveal metastasis is the most common intraocular malignancy and can often be the presenting finding for the primary tumor (Konstantinidis et al. 2014; Shields et al. 1997a, b). Within the uveal tract, metastatic lesions most commonly locate to the choroid (88% of cases) and less frequently to the iris (9% of cases) and the ciliary body (2% of cases) (Shields et al. 1997a, b). Histologic studies have suggested that, of patients that have died with metastatic carcinoma, an estimated 5% may have ocular involvement (Eliassi-Rad et al. 1996). Uveal metastasis is the most common intraocular malignancy. Metastases are usually amelanotic, without visible intratumoral vessels, with a medium internal acoustic reflectivity on ultrasonography and a lumpy surface on optical coherence tomography. The most common primary sites are lung and cancer. In many patients, the ocular metastasis is the first sign of malignancy. In these patients, the primary tumor can be identified by systemic imaging or by intraocular tumor biopsy. Uveal metastases grow rapidly so that treatment is urgent. Some ocular metastases regress with systemic therapy; otherwise, treatment consists of various forms of radiotherapy, laser therapy, or photodynamic therapy. Special care should be taken to provide psychological support to patients and their family in view of the distressing nature of this condition.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Greg Bever
    • 1
  • Armin Afshar
    • 1
  • Bertil Damato
    • 1
    • 2
  1. 1.Department of OphthalmologyUniversity of CaliforniaSan FranciscoUSA
  2. 2.Nuffield Department of Clinical NeurosciencesWest Wing, John Radcliffe Hospital, University of OxfordOxfordUK

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