Choroidal Metastasis in Myriad of Primary Malignancies: A Cross-sectional Study

Abstract

Introduction: All metastatic malignancies commonly metastasise to choroid tissue in eye due to its peculiarity in vascular properties; thereof ocular manifestations are most common in the practice of oncology and ophthalmology. Aim: To investigate the prevalence and clinical pattern of choroidal metastases in myriad of primary malignancies Materials and Methods: This cross-sectional study was conducted from December 2017 to July 2019 , at Krishna Institute of Medical Sciences, Karad, Maharashtra, on 253 patients with confirmed diagnosis of primary malignancies of breast, lung and ovary with one or more distant metastases with or without ocular symptoms. All patients underwent thorough ophthalmic examination, Ultrasonography (USG) and Magnetic Resonance Imaging (MRI). The continuous and categorical variables were presented in mean±standard deviation and percentages, respectively. Results: Out of 253 patients, 49 (19.4%) were of breast carcinoma, 52 (20.5%) of lung carcinoma, 127 (50.2%) had gastrointestinal tract malignancy, 8 (3.2%) were of renal cell carcinoma, and 17 (6.7%) had prostate carcinomas. Prevalence of choroidal metastases was 5 (1.9%) of which 1 (20%) in breast and 2 (40%) each in lung, and gastrointestinal carcinomas. Patients with choroidal metastasis were presented with diplopia, pain, and diminished vision. Out of five patients with choroidal metastasis, three patients had choroidal metastasis on right and two had on left-side. Amongst these patients, three had advanced disease, two had retinal detachment, and one had vitreous haemorrhage. USG revealed polygonal heterogeneous echoic mass lesion with irregular surface contour and internal vascularity. MRI revealed T1 isointense, T2 hypointensity well demarcated nodular mass lesion with broad base. Conclusion: The prevalence of choroidal metastases is very less and tends to occur in the patients with advanced disease.