Metastatic tumors of the uvea in 38 eyes.

BACKGROUND

The reported incidence of metastatic uveal tumors has been increasing. The aim of this study is to report the clinical features, management, and prognosis of uveal metastatic tumors seen in a general oncology hospital.

METHODS

The records of 28 patients with uveal metastasis diagnosed between 1999 and 2006 were reviewed retrospectively.

RESULTS

Uveal metastatic tumours were detected in a total of 38 eyes, uveal involvement included the iris in 4 eyes and the choroid in 37 eyes. Ten patients (35.7%) had bilateral uveal involvement. The primary cancer site was the breast in 24 patients, the lung in 2 patients, the ovary in 1 patient, and the gastrointestinal tract in 1 patient. While the most common symptom was blurred vision, 14.2% of patients were asymptomatic. Choroidal metastases typically were creamy yellow in color, plateau or dome-shaped, and associated with secondary retinal detachment in 56.8% of eyes. The mean time interval between ocular and systemic diagnosis was 41.07 months. At the time of ocular diagnosis, 75% of patients had systemic metastasis. Eight eyes were treated with chemotherapy and hormone therapy, and external beam radiotherapy was applied to 30 eyes. Lesions commonly responded well to therapy, but 22 patients died as a result of disseminated systemic disease.

INTERPRETATION: Patients with uveal metastasis generally present to ophthalmologists with visual symptoms but may be asymptomatic in some cases. Local tumor control can be managed with current therapy, but systemic prognosis is generally poor because of the disseminated stage of the malignant disease.