Metastatic Choroidal Tumor

Published on 09/05/2015 by admin

Filed under Opthalmology

Last modified 22/04/2025

Print this page

This article have been viewed 1477 times

23.1

Metastatic Choroidal Tumor

Introduction:

Choroidal metastatic lesions are the most common intraocular tumor in adults. The most common primary sites are breast and lung.

Clinical Features:

These lesions are typically creamy, yellow, and elevated. They tend to be bilateral and can also be multifocal (Fig. 23.1.1). Associated serous retinal detachments can cause decreased visual acuity when involving the macula. A history of primary malignancy is helpful in confirming the diagnosis.

Figure 23.1.1 Color fundus photo shows numerous creamy, yellowish, circular, minimally elevated choroidal tumors within the posterior pole in a patient with pulmonary metastases.

OCT Features:

There is a localized elevation of the choroid in the location of the tumor, which can have overlying subretinal fluid (Fig. 23.1.2). Cystoid intraretinal fluid overlying the tumor can also be present (Figs 23.1.3 and 23.1.4).

Figure 23.1.2 OCT (corresponding to Figure 23.1.1) shows a hill-like elevation of the choroid due to infiltration by the tumor with mild obscuration of the choriocapillaris. There is overlying subretinal fluid.

Figure 23.1.3 OCT of a large metastatic choroidal tumor involving the optic nerve and macula shows a hyporeflective elevation of the choroid that is infiltrated by tumor. Overlying this is subretinal fluid and extensive CME. The inner retinal layers are somewhat more hyper-reflective than normal.

Figure 23.1.4 Fluorescein angiography (corresponding to Figure 23.1.1) shows multiple areas of pinpoint hyperfluorescence overlying each area of choroidal infiltration.