BILATERAL CHOROIDAL METASTASIS WITH CONCURRENT UNILATERAL RHEGMATOGENOUS RETINAL DETACHMENT IN A PATIENT WITH STAGE IV BREAST CANCER.

PURPOSE: To describe an unusual case of bilateral choroidal metastasis with simultaneous rhegmatogenous retinal detachment in the right eye.

METHODS

Case Report.

PATIENT: A 65-year-old woman with Stage IV breast cancer and gradual deterioration of vision in the right eye.

RESULTS

Dilated fundus examination of the right eye revealed a large solitary choroidal mass with exudative retinal detachment and with an incidental discovery of a lower peripheral break with subretinal fluid, and the left eye revealed multiple choroidal masses. The diagnosis of bilateral CM was confirmed using optical coherence tomography. Pars plana vitrectomy with silicone oil injection was performed for the right eye followed by external beam radiotherapy to both choroids, which resulted in anatomical and visual success for 6 months.

CONCLUSION

Prompt ophthalmologic evaluation is a must in patients with advanced breast or lung malignancy with recent blurring of vision. External beam radiotherapy is a safe, available, relatively cheap, and effective means for managing CM. Choroidal metastasis with a concurrent vision-threatening pathology requiring intraocular surgery represents a dilemma, and the risks and benefits should be weighed carefully with proper counseling of the patient.