Abstract
Abstract: :
Purpose: Reporting the clinical features of patients with uveal metastases on initial presentation at an ocular oncology center Methods: A retrospective chart review was performed on all patients with uveal metastases at an ocular oncology center over a 7 year period Results: 25 eyes in 21 patients (14 female, 7 male; age 35 to 90 years old) were diagnosed with uveal metastases. 17 (81.0%) had unilateral uveal metastases & 4 (19.0%) had bilateral involvement. 23 eyes (92.0%) involved the choroid, 2 (8.0%) involved the iris, & none involved the ciliary body. Of the 23 eyes involving the choroid, 12 (60.0%) had subretinal fluid (SRF) associated with the tumor, 8 (40.0%) had no SRF, & 3 were undetermined. Of the eyes with choroidal involvement, 19 (82.6%) had a single lesion, 2 (8.7%) had 2 separate lesions, and 2 (8.7%) had multiple (>8) diffuse lesions. Both eyes with iris metastases had a single lesion located on the superior portion of the iris. 20 patients were symptomatic upon presentation, while 1 was asymptomatic. Of the 25 eyes, 22 were symptomatic, while 3 were asymptomatic. The most common symptoms were decreased vision in 18 (72.0%) of the eyes, visual field defect in 6 (24.0%), pain in 4 (16.0%), photophobia in 4 (16.0%), floaters in 4 (16.0%), photopsias in 3 (12.0%), dyschromatopsia in 2 (8.0%), & metamorphopsia in 1 (4.0%). Of the 18 eyes symptomatic for decreased vision, 11 (61.1%) had a BCVA of 20/200 or worse, 4 (22.2%) were in the range of 20/50 to 20/100, & 3 (16.7%) had a BCVA of 20/40 or better. At the time of presentation, 20 patients (95.2%) reported a history of cancer: 17 (85.0%) had known metastases in other location, while 3 (15.0%) had no other known metastases. 1 patient had no prior history of cancer. Of the 21 patients, the primary tumor was of the breast in 9 (42.9%), the lung in 7 (33.3%), cutaneous melanoma in 2 (9.5%), prostate in 1 (4.8%), adenoid cystic carcinoma of the oral mucosa in 1 (4.8%), and unknown in 1 (4.8%). Of the females, the primary tumor was of the breast in 9 (64.3%), the lung in 4 (28.6%), and cutaneous melanoma in 1 (7.1%). Of the 7 males, the primary tumor was of the lung in 3 (42.9%), prostate in 1 (14.3%), cutaneous melanoma in 1 (14.3%), and unknown in 1 (14.3%). Conclusions: The choroid was the most common site for uveal metastases. The majority of patients had only a single lesion, with most of these found in the posterior pole. The most common symptom was decreased vision. Overall, the most common primary tumor was breast, followed by lung cancer. In men, the most common primary tumor was lung cancer; in women it was breast cancer.
Keywords: tumors • uvea • choroid