Choroidal Metastasis:Case Reports And Review Of The Literature

Choroidal metastases are rare diseases of the eye, but they are recognized as one of the most common intraocular malignancy. Due to increased incidence of cancer, the incidence of choroidal metastasis also increased. The most common primary site in patients diagnosed with choroidal metastases is the lung in China. This thesis reports three cases of choroidal metastases and reviews the literature of choroidal metastasis including the incidence, clinical features, ancillary tests, differential diagnoses and treatment. In case1and case2, two patients were diagnosed with choroidal metastases of non-small cell lung adenocarcinoma without previous history of cancer. In case3, one patient was diagnosed with choroidal metastases of a resected esophageal cancer. Review of the literature showed the chief symptoms of choroidal metastases are blurred vision or decreased vision. Choroidal metastases usually manifest as yellow, creamy, plateau shaped subretinal lesions, often in the posterior pole of the eye fundus with secondary retinal detachment. Differential diagnoses of choroidal metastasis should be made from malignant choroidal melanoma, choroidal hemangioma, choroidal osteoma, and choroidal nevus. For patients with clinically suspected choroidal metastasis, ultrasound examination, computed tomography, magnetic resonance imaging, fundus fluorescein angiography or even fine-needle aspiration biopsy would be used to make a correct diagnosis and to find out the primary lesion as early as possible. Prognosis is poor for patients diagnosed with choroidal metastasis. There are a wide variety of treatment options for patients with choroidal metastases, such as chemotherapy, radiation therapy, laser therapy, intravitreal injection of angiogenesis inhibitors, enucleation, etc. The main purpose of treatment is to protect the vision, relieve pain, and improve the quality of life of the patients.