Intraocular metastasis is a significant clinical problem in patients with metastatic cancer. The frequency of intraocular metastasis in all patients dying of cancer is approximately 12%, but in breast cancer patients, the frequency can be as high as 37%.
Methods
A review of pertinent literature and the author's experience are used to describe the epidemiology, diagnosis, and management of metastatic tumors of the eye.
Results
Intraocular metastases occur frequently and are diagnosed by ophthalmologic examination. Radiotherapy remains the cornerstone of therapy and allows the majority of patients to maintain useful vision for the remainder of their lives.
Conclusions
The recognition and treatment of intraocular metastasis are important clinical oncologic issues. With proper management, patients with ocular metastasis can maintain vision and thus maximize quality of life.
Get full access to this article
View all access options for this article.
References
1.
PerlsM.Contributions to pathology of tumors. Virchows Arch Pathol Anat.1872; 56: 437.
2.
LemoineA.N., McLeodJ.Bilateral metastatic carcinoma of the choroid. Arch Ophthalmol.1936; 15: 804–821.
3.
GodtfredsenE.On the frequency of secondary carcinomas in the choroid. Acta Ophthalmol.1944; 22: 394–400.
NelsonC.C., HertzbergB.S., KlintworthG.D.A histopathologic study of 716 unselected eyes in patients with cancer at the time of death. Am J Ophthalmol.1983; 95: 788–793.
6.
Eliassi-RadB., AlbertD.M., GreenW.R.Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol.1996; 80: 125–128.
7.
AlbertD.M.Tumor metastasis to the eye: tumor incidence in 213 adult patients with generalized malignancy. Am J Ophthalmol.1967; 63: 723–726.
8.
ShieldsJ.A., ShieldsC.L.Intraocular Tumors: A Text and Atlas.4th ed.Philadelphia, Pa: WB Saunders Co; 1992: 208–238.
9.
FerryA.P., FontR.L.Carcinoma metastatic to the eye and orbit. I: A clinicopathologic study of 227 cases. Arch Ophthalmol.1974; 92: 276–286.
10.
FreedmanM.I., FolkJ.C.Metastatic tumors to the eye and orbit: patient survival and clinical characteristics. Arch Ophthalmol.1987; 105: 1215–1219.
11.
ShieldsC.L., ShieldsJ.A., GrossN.E.Survey of 520 eyes with uveal metastases. Ophthalmology.1997; 104: 1265–1276.
12.
MewisL., YoungS.E.Breast carcinoma metastatic to the choroid: analysis of 67 patients. Ophthalmology.1982; 89: 147–151.
13.
MichelsonJ.B., StephensR.F., ShieldsJ.A.Clinical conditions mistaken for metastatic cancer to the choroid. Ann Ophthalmol.1979; 11: 149–153.
14.
MerrillC.F., KaufmanD.I., DimitrovN.V.Breast cancer metastatic to the eye is a common entity. Cancer.1991; 68: 623–627.
15.
ColemanD.J., AbramsonD.H., JackR.L.Ultrasonic diagnosis of tumors of the choroid. Arch Ophthalmol.1974; 91: 344–354.
RatanatharathornV., PowersW.E., GrimmJ.Eye metastasis from carcinoma of the breast: diagnosis, radiation treatment and results. Cancer Treat Rev.1991; 18: 261–276.
29.
ReddyS., SaxenaV.S., HendricksonF.Malignant metastatic disease of the eye: management of an uncommon complication. Cancer.1981; 47: 810–812.
30.
RudolerS.B., ShieldsC.L., CornB.W.Functional vision is improved in the majority of patients treatment with external-beam radiotherapy for choroid metastases: a multivariate analysis of 188 patients. J Clin Oncol.1997; 15: 1244–1251.
31.
ThatcherN., ThomasP.R.Choroidal metastases from breast carcinoma: a survey of 42 patients and the use of radiation therapy. Clin Radiol.1975; 26: 549–553.
32.
WiegelT., BornfeldN., KreuselK.M.Radiotherapy for choroidal metastases: interim analysis of a prospective study of the ARO (ARO 95–08). Front Radiat Ther Oncol.1997; 30: 154–159.
33.
ShieldsC.L., ShieldsJ.A., De PotterP.Plaque radiotherapy for the management of uveal metastasis. Arch Ophthalmol.1997; 115: 203–209.
34.
AntebyI., Pe'erJ., UzielyB.Thyroid carcinoma metastasis to the choroid responding to systemic 131I therapy. Am J Ophthalmol.1992; 113: 461–462.
35.
LetsonA.D., DavidorfF.H., BruceR.A.Jr. Chemotherapy for treatment of choroidal metastases from breast carcinoma. Am J Ophthalmol.1982; 93: 102–106.
36.
FanJ.T., OrtizR.G., BuettnerH.Regression of choroidal metastases from a bronchial carcinoid tumor after chemotherapy with cisplatin and etoposide. Am J Ophthalmol.1994; 117: 111–113.
37.
ParsonsJ.T., BovaF.J., FitzgeraldC.R.Radiation retinopathy after external-beam irradiation: analysis of time-dose factors. Int J Radiat Oncol Biol Phys.1994; 30: 765–773.
38.
RudolerS.B., CornB.W., ShieldsC.L.External beam irradiation for choroid metastases: identification of factors predisposing to long-term sequelae. Int J Radiat Oncol Biol Phys.1997; 38: 251–256.
