[Optic disc metastasis from pulmonary adenocarcinoma]

Ocular metastases are becoming less and less rare. However, the optic nerve remains an exceptional site of metastases. Metastases to the optic disc account only for 4.5% of all intraocular metastases and are most of the time accompanied by an adjacent juxtapapillary choroidal component.

We report the case of a 65 year-old man presenting an unilateral impairment of visual acuity at the left eye. This man is treated for lung cancer. The left optic disc shows a diffuse yellow thickening and flame-shaped hemorrhages. The diagnosis of an optic disc metastasis was retained according to the ophthalmoscopy and various complementary investigations.

The optic disc metastasis can occur in a well-known cancer history but may sometimes be the first manifestation of it. Breast and lung cancers are the most common primary neoplasms. Women are more affected than men. The mean age at the time of ocular diagnosis is 55 years. The prognosis is poor because optic nerve metastases occur in advanced metastatic cancer. The mean survival is 13 months after ocular diagnosis. The mean treatments are external radiotherapy associated with systemic chemotherapy.

Presence of an optic disc lesion may suggest the possibility of a papillary metastasis despite the lack of a cancer history.