Clinical Features of Retinal Metastases

Abstract

Purpose: To report a cohort of patients diagnosed with retinal metastases (RM), and to integrate these new cases in a systematic review of the literature, analyzing the clinical features and prognosis factors of patients with RM.Methods: We conducted a retrospective multicenter study including patients with RM. We also performed a full literature review of all published cases with a diagnosis of RM.Results: A total of six new cases were described on multimodal imaging. By combining the data from the literature and from our patients, we report the characteristics of a total of 69 patients. The most frequent primary tumor sites were cutaneous melanoma (36%), lung (23%), gastrointestinal tract (17%), and breast (12%). Multimodal imaging highlighted specific characteristics of RM. Fluorescein and indocyanine green angiography revealed early hypofluorescence followed by progressive filling of intrinsic dilated vessels. Optical coherence tomography demonstrated a hyperreflective intraretinal mass in all cases with or without subretinal fluid, hyperreflective intraretinal dots, or intraretinal fluid. Ultrasonography revealed a medium-high reflective dome-shaped tumor. Fifty-nine percent of the patients died during the follow-up with a mean survival time of 8.8 ± 8.7 months. Conclusion:We described here the clinical spectrum of RM and highlighted specific features of the disease.

Posterior segment manifestations of ocular metastasis

“…This lower prevalence can be explained by the presence of inner and outer blood–retinal barriers, which limit the penetration of metastatic cells into the retina due to its nonfenestrate nature [16]. Most patients with retinal metastasis have a known primary site, with cutaneous melanoma the most common [6 ▪▪ ]. Although lung cancer, gastrointestinal carcinomas, and breast cancer can occasionally metastasize to the retina, they are less frequent [6 ▪▪ ].…”

“…Most patients with retinal metastasis have a known primary site, with cutaneous melanoma the most common [6 ▪▪ ]. Although lung cancer, gastrointestinal carcinomas, and breast cancer can occasionally metastasize to the retina, they are less frequent [6 ▪▪ ].…”

“…A recent systematic review has highlighted the multimodal imaging features of retinal metastases [6 ▪▪ ]. Ultrasound reveals the thickening of the retina with medium to high internal reflectivity.…”

“…Among uveal metastases, the choroid is the most frequently involved (89%), followed by the iris (9%) and the ciliary body (2%) [3]. Although less common, the retina, vitreous, and optic disc are also affected by ocular metastases [4,5 ▪ ,6 ▪▪ ]. The most common primary sites associated with ocular metastases are breast cancer in women and lung cancer in men [7].…”