OBJECTIVE: To study the clinical characteristics of choroidal metastasis (CM) to promote the early diagnosis and differentiate from other choroidal tumors. METHODS: Retrospective clinical observational cases. All patients with choroidal metastasis underwent ophthalmologic examination including best corrected visual acuity (VA), slit-lamp examination, binocular indirect funduscopy, color photography, fundus fluorescein angiography (FFA), indocyanine-green angiography (ICGA), optical coherence tomography (OCT), A and B scan ultrasound examination, magnetic resonance image (MRI) as well as CT of the thorax, etc. RESULTS: Nine eyes of 5 patients with CM were examined. Unilateral choroidal involvement was present in 1 patient, bilateral in 4 cases. There were 1 case male and 4 case females. The age of these patients ranged from 31 to 56 years, median 45 years. Ocular symptoms included reduced vision in 4 patients and visual distortion in 1 patient. Visual acuity was 20/400- < 20/63 in four eyes; 20/63- < 20/30 in two eyes and >or= 20/30 in three eyes. The primary cancer site was in the lung in 3 patients, in the breast in 1 patient and in the stomach in 1 patient. Fundus characteristics: Typical CM was more often in the plateau-shaped than in the dome-shaped; yellow-white or mottled in color and associated with subretinal fluid and retinal detachment. The tumor was found in the macular area and juxtapapillary area in 6 eyes, in the area between the macula and the equator in 3 eyes. CM was solitary in 5 eyes and showed multiple lesions in 4 eyes. By FA the lesions showed mottled hyperfluorescence in early stage and leakage in late stage. By ICGA the lesion showed blocked fluorescence and hypofluorescence. Choroidal mass showed moderate irregular internal reflectivity in A-scan ultrasound. B-scan showed a plateau-shaped solid mass. MRI examination of the lesion revealed moderate short T1W and T2W signals. The cancer antigen increased to 16.28 and 4.95 microg/L in two cases. CA125 increased to 160.5 kU/L in one case. CONCLUSIONS: The choroid is the most common site for metastases. CM may precede the diagnosis of primary tumor. Evaluation of A, B scan ultrasound, CT of thorax and cancer antigen test may be important to exclude primary carcinoma from lung and breast in patients with yellow-white in color, plateau-shaped choroidal lesions, especially in both eyes, and without known metastatic diseases.
OBJECTIVE: To study the clinical characteristics of choroidal metastasis (CM) to promote the early diagnosis and differentiate from other choroidal tumors. METHODS: Retrospective clinical observational cases. All patients with choroidal metastasis underwent ophthalmologic examination including best corrected visual acuity (VA), slit-lamp examination, binocular indirect funduscopy, color photography, fundus fluorescein angiography (FFA), indocyanine-green angiography (ICGA), optical coherence tomography (OCT), A and B scan ultrasound examination, magnetic resonance image (MRI) as well as CT of the thorax, etc. RESULTS: Nine eyes of 5 patients with CM were examined. Unilateral choroidal involvement was present in 1 patient, bilateral in 4 cases. There were 1 case male and 4 case females. The age of these patients ranged from 31 to 56 years, median 45 years. Ocular symptoms included reduced vision in 4 patients and visual distortion in 1 patient. Visual acuity was 20/400- < 20/63 in four eyes; 20/63- < 20/30 in two eyes and >or= 20/30 in three eyes. The primary cancer site was in the lung in 3 patients, in the breast in 1 patient and in the stomach in 1 patient. Fundus characteristics: Typical CM was more often in the plateau-shaped than in the dome-shaped; yellow-white or mottled in color and associated with subretinal fluid and retinal detachment. The tumor was found in the macular area and juxtapapillary area in 6 eyes, in the area between the macula and the equator in 3 eyes. CM was solitary in 5 eyes and showed multiple lesions in 4 eyes. By FA the lesions showed mottled hyperfluorescence in early stage and leakage in late stage. By ICGA the lesion showed blocked fluorescence and hypofluorescence. Choroidal mass showed moderate irregular internal reflectivity in A-scan ultrasound. B-scan showed a plateau-shaped solid mass. MRI examination of the lesion revealed moderate short T1W and T2W signals. The cancer antigen increased to 16.28 and 4.95 microg/L in two cases. CA125 increased to 160.5 kU/L in one case. CONCLUSIONS: The choroid is the most common site for metastases. CM may precede the diagnosis of primary tumor. Evaluation of A, B scan ultrasound, CT of thorax and cancer antigen test may be important to exclude primary carcinoma from lung and breast in patients with yellow-white in color, plateau-shaped choroidal lesions, especially in both eyes, and without known metastatic diseases.