Clinical spectrum of choroidal metastasis in Korean patients based on primary tumor origin

Abstract

Purpose : To evaluate patients with choroidal metastasis based on primary tumor site in Korean patients.

Methods : Retrospective case series of consecutive patients diagnosed at 2 tertiary referral-based centers from November 2005 to November 2019. Clinical features and outcomes were evaluated based on the primary tumor site.

Results : There were 128 choroidal metastases diagnosed in 95 eyes of 80 patients. The mean age at diagnosis was 56.4 years (median 56.5, range 24-86), with a minor female preponderance (61%). The tumors were unilateral in 65 (81%) patients and the primary origin had been established in 50 (63%) prior to the detection of choroidal metastases. The primary tumor originated in the lung (48%), breast (24%), gastrointestinal (GI) tract (10%), liver (3%), pancreas (3%), kidney (1%), cervix (1%), and nasopharynx (1%), with a small percentage remaining unknown even after extensive evaluation (10%). The demographics and clinical features of the top 3 most common primary sites (lung, breast, and GI tract) were further analyzed: mean age at diagnosis of choroidal metastasis was 56, 52, and 68 years respectively, and were unilateral in 79%, 79%, and 100% of cases with a mean number of metastasis per eye of 1.2, 1.4, and 1.5. Female preponderance was noted in the lung- and breast-cancer groups (58% and 100%, respectively), but not in the GI tract-cancer group (12.5%). The largest tumor in any 1 eye was evaluated for comparison: choroidal metastasis measured a mean base of 9.4, 10.4, and 5.3 mm respectively, with a mean thickness of 3.2, 3.5 and 5.2 mm, demonstrating a predominantly yellow color in 85%, 87%, and 88% of cases. Of the 65 (81%) patients with documented follow-up, the mean patient survival was 19.2, 22.4, and 38.2 months; Kaplan-Meier analysis revealed a 3-year survival of 22%, 14% and 33% respectively, and a 5-year survival of 6%, 7%, and 17%. The worst survival was found in patients with liver cancer (mean 0.2 months), and the best survival with GI tract cancers (17% at 5 years).

Conclusions : The primary tumor origin in Korea patients differs from those reported in primarily Caucasian population-based studies, with a much higher prevalence of lung and GI tract cancers. Overall prognosis is poor with a 5-year survival rate of 7%.

This is a 2020 ARVO Annual Meeting abstract.