Clinical approach for solid intraocular metastases

Abstract

Intraocular metastases arising from solid tumors are found in approximately 2% of patients with metastatic tumor diseases and are therefore more frequent than originally assumed. They often affect the uvea and are associated with apoor prognosis. Due to the difficult diagnosis and an inconsistent treatment regimen, ophthalmologists have aspecial responsibility here. This article gives a summary of the various types of intraocular metastases with respect to clinical features, diagnostics, treatment and prognosis as well as recommendations for follow-up care. A selective literature search was carried out on the topic of intraocular metastases using PubMed and Google Scholar. Intraocular metastases most frequently affect the uvea, specifically the choroid. In most cases the underlying disease is breast or lung cancer, but other rarer primary tumors have also been reported in the literature. Metastatic lesions can show very different morphological manifestations but can be distinguished based on the corresponding structure of manifestation in the eye and with the aid of targeted staging, thus providing valid information on the type of primary tumor. The treatment is partly experimental and usually depends on the primary tumor and leading symptoms of the patient. A differentiation between acurative or palliative treatment situation must always be made. Intraocular metastases are the most frequent intraocular tumor and are usually associated with apoor prognosis. Accurate diagnostics for finding the treatment as well as interdisciplinary collaboration and the presentation of the patient on the tumor board are essential.