Abstract
Metastasis to the eye involves the choroid (88%), iris (9%), or ciliary body (2%), and rarely the retina (<1%). Intraocular metastases most commonly originate from primary cancers in the breast (47%), lung (21%), gastrointestinal tract (4%), kidney (2%), skin (melanoma) (2%), prostate gland (2%), and other sites (4%). Metastases are unilateral in 76% of cases and bilateral in 24%. Patient prognosis is poor, and those with metastatic skin melanoma or lung carcinoma typically show survival less than 1 year. Those with metastases from breast cancer show survival of 65% at 1 year, 34% at 3 years, and 24% at 5 years.
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Jemal A, Thun MJ, Ries LA, Howe HL, Weir HK, Center MM, Ward E, Wu XC, Eheman C, Anderson R, Ajani UA, Kohler B, Edwards BK. Annual report to the nation on the status of cancer, 1975–2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Cancer Inst. 2008;100:1672–94.
Shields CL, Shields JA, Gross NE, et al. Survey of 520 eyes with uveal metastases. Ophthalmology. 1997;104:1265–76.
Duke-Elder S. System of ophthalmology, Diseases of the uveal tract, vol. 9. St. Louis: CV Mosby; 1966. p. 917.
Hart WM. Metastatic carcinoma to the eye and orbit. Int Ophthalmol Clin. 1962;212:465–82.
Albert DM, Rubenstein RA, Scheie HG. Tumors metastasis to the eye. I. Incidence in 213 adult patients with generalized malignancy. Am J Ophthalmol. 1967;63:723–6.
Jensen OA. Metastatic tumors of the eye and orbit. A histopathological analysis of a Danish series. Acta Pathol Microbiol Scand Suppl. 1970;212:201–14.
Bloch RS, Gartner S. The incidence of ocular metastatic carcinoma. Arch Ophthalmol. 1971;85:673–5.
Ferry AP, Font RL. Carcinoma metastatic to the eye and orbit. I. A clinicopathologic study of 227 cases. Arch Ophthalmol. 1974;92:276–86.
Stephens RF, Shields JA. Diagnosis and management of cancer metastatic to the uvea: a study of 70 cases. Ophthalmology. 1979;86:1336–49.
Nelson CC, Hertzberg BS, Klintworth GK. A histopathologic study of 716 unselected eyes in patients with cancer at the time of death. Am J Ophthalmol. 1983;95:788–93.
Freedman MI, Folk JC. Metastatic tumors to the eye and orbit. Patient survival and clinical characteristics. Arch Ophthalmol. 1987;105:1215–9.
Eliassi-Rad B, Albert DM, Green WR. Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol. 1996;80:125–8.
Shields JA, Shields CL, Singh AD. Metastatic neoplasms in the optic disc: the 1999 Bjerrum Lecture: part 2. Arch Ophthalmol. 2000;118:217–24.
Bullock JD, Yanes B. Ophthalmic manifestations of metastatic breast cancer. Ophthalmology. 1980;87:961–73.
Merrill CF, Kaufman DI, Dimitrov NV. Breast cancer metastatic to the eye is a common entity. Cancer. 1991;68:623–7.
Mewis L, Young SE. Breast carcinoma metastatic to the choroid. Analysis of 67 patients. Ophthalmology. 1982;89:147–51.
Demirci H, Shields CL, Chao A, Shields JA. Uveal metastasis from breast cancer in 264 patients. Am J Ophthalmol. 2003;136:264–71.
Amichetti M, Caffo O, Minatel E, et al. Ocular metastases from breast carcinoma: a multicentric retrospective study. Oncol Rep. 2000;7:761–5.
Wickremasinghe S, Dansingani KK, Tranos P, Liyanage S, Jones A, Davey C. Ocular presentations of breast cancer. Acta Ophthalmol Scand. 2007;85:133–42.
Tamura M, Tada T, Tsuji H, Tamura M, Yoshimoto M, Takahashi K, Tada K, Tanabe M, Kutomi G, Sekine Y, Kasumi F. Clinical study on the metastasis to the eyes from breast cancer. Breast Cancer. 2004;11:65–8.
De Potter P, Shields CL, Shields JA, Tardio DJ. Uveal metastasis from prostate carcinoma. Cancer. 1993;71:2791–6.
Font RL, Naumann G, Zimmerman LE. Primary malignant melanoma of the skin metastatic to the eye and orbit. Report of ten cases and review of literature. Am J Ophthalmol. 1967;63:438–554.
Fishman ML, Tomaszewski MM, Kuwabara T. Malignant melanoma of the skin metastatic to the eye. Frequency in autopsy series. Arch Ophthalmol. 1976;94:1309–11.
Debustros S, Augsburger JJ, Shields JA, et al. Intraocular metastases from cutaneous malignant melanoma. Arch Ophthalmol. 1985;103:937–40.
Zografos L, Ducrey N, Beati D, Schalenbourg A, Spahn B, Balmer A, Othenin-Girard CB, Chamot L, Egger E. Metastatic melanoma in the eye and orbit. Ophthalmology. 2003;110:2245–56.
Harbour JW, De Potter P, Shields CL, Shields JA. Uveal metastasis from carcinoid tumor: clinical Âobservations in nine cases. Ophthalmology. 1994;101:1084–90.
Shields JA, Shields CL. Metastatic tumors to the intraocular structures. Intraocular tumors: a text and atlas. Philadelphia: Saunders; 1992. p. 207–38.
Shields JA, Shields CL. Metastatic tumors to the uvea, retina, and optic disc. Intraocular tumors. An atlas and textbook. Philadelphia: Williams & Wilkins; 2008. p. 197–228.
Shields JA, Shields CL, Kiratli H, DePotter P. Metastatic tumors to the iris in 40 patients. Am J Ophthalmol. 1995;119:422–40.
Kamby C, Ejlertsen B, Andersen J, et al. The pattern of metastases in human breast cancer. Influence of systemic adjuvant therapy and impact on survival. Acta Oncologica. 1988;27:715–9.
O’Brien J, Wieland M, Filer R. Breast cancer metastatic to the choroid in a male patient. Retina. 2000;2:214–6.
Lam A, Shields CL, Shields JA. Uveal metastases from breast cancer in three male patients. Ophthalmic Surg Lasers Imaging. 2006;37:320–3.
Soysal HG. Metastatic tumors of the uvea in 38 eyes. Can J Ophthalmol. 2007;42:832–5.
Shields JA, Shields CL. Posterior uveal melanoma: clinical and pathologic features. In: Intraocular tumors: a text and atlas. Philadelphia: Saunders; 1992. p. 117–36.
Michelson JB, Stephens RF, Shields JA. Clinical conditions mistaken for metastatic cancer to the choroid. Ann Ophthalmol. 1979;11:149–53.
Shields CL, Honavar SG, Shields JA, et al. Circumscribed choroidal hemangioma. Clinical manifestations and factors predictive of visual outcome in 200 consecutive cases. Ophthalmology. 2001;108:2237–48.
Shields CL, Shields JA, Augsburger JJ. Review of choroidal osteomas. Surv Ophthalmology. 1988;33:17–27.
Gündüz K, Shields JA, Shields CL, Eagle Jr RC. Cutaneous melanoma metastatic to the vitreous cavity. Ophthalmology. 1998;105:600–5.
Lim JI. Paraneoplastic syndromes. O’Brien J, ed. Ophthalmol Clin North Am. 1999;12:213–224.
Shields CL, Shields CL, De Potter P. Patterns of indocyanine green angiography of choroidal tumors. Br J Ophthalmol. 1995;79:237–45.
Arevalo JF, Fernandez CF, Garcia RA. Optical coherence tomography characteristics of choroidal metastasis. Ophthalmology. 2005;112:1612–9.
De Potter P, Shields JA, Shields CL, et al. Metastatic carcinoma to the choroid and optic nerve: unusual magnetic resonance imaging findings. Int Ophthalmol. 1992;16:39–44.
Shields JA, Shields CL, Ehya H, et al. Fine needle aspiration biopsy of suspected intraocular tumors. The 1992 urwick lecture. Ophthalmology. 1993;100:1677–84.
Shields CL, Manquez ME, Ehya H, Mashayekhi A, Danzig CJ, Shields JA. Fine-needle aspiration biopsy of iris tumors in 100 consecutive cases: technique and complications. Ophthalmology. 2006;113:2080–6.
Char DH. Treatment of choroidal metastases. Arch Ophthalmol. 1991;18:333.
Kuo IC, Haller JA, Maffrand R, Sambuelli RH, Reviglio VE. Regression of a subfoveal choroidal metastasis of colorectal carcinoma after intravitreous bevacizumab treatment. Arch Ophthalmol. 2008;126:1311–3.
Levinger S, Merin S, Seigal R, Pe’er J. Laser therapy in the management of choroidal breast tumor metastases. Ophthalmic Surg Lasers. 2001;32:294–9.
Harbour JW, Meredith TA, Thompson PA, Gordon ME. Transpupillary thermotherapy versus plaque radiotherapy for suspected choroidal melanomas. Ophthalmology. 2003;110:2207–14.
Vianna RN, Pena R, Muralha A, Muralha L, Muranaka E. Transpupillary thermotherapy in the treatment of choroidal metastasis from breast carcinoma. Int Ophthalmol. 2004;25:23–6.
Rudoler SB, Corn BW, Shields CL, et al. External beam irradiation for choroid metastases: identification of factors predisposing to long-term sequelae. Int J Radiat Oncol Biol Phys. 1997;1(38):251–6.
Rudoler SB, Shields CL, Corn BW, et al. Functional vision is improved in the majority of patients treated with external-beam radiotherapy for choroid metastases: a multivariate analysis of 188 patients. J Clin Oncol. 1997;15:1244–51.
Shields CL, Shields JA, De Potter P, et al. Plaque radiotherapy in the management of uveal metastasis. Arch Ophthalmol. 1997;115:203–9.
Shields JA, Shields CL, Shah P, Sivalingam V. Partial lamellar sclerouvectom y for ciliary body and choroidal tumors. Ophthalmology. 1991;98:971–83.
Rodriques M, Shields JA. Iris metastasis from a bronchial carcinoid tumor. Arch Ophthalmol. 1978;96:77–83.
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Shields, C.L., Shields, J.A. (2013). Choroidal and Retinal Metastasis. In: Arévalo, J. (eds) Retinal and Choroidal Manifestations of Selected Systemic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3646-1_14
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DOI: https://doi.org/10.1007/978-1-4614-3646-1_14
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