[Clinical characteristics of choroidal metastasis]

To study the clinical characteristics of choroidal metastasis (CM) to promote the early diagnosis and differentiate from other choroidal tumors.

Retrospective clinical observational cases. All patients with choroidal metastasis underwent ophthalmologic examination including best corrected visual acuity (VA), slit-lamp examination, binocular indirect funduscopy, color photography, fundus fluorescein angiography (FFA), indocyanine-green angiography (ICGA), optical coherence tomography (OCT), A and B scan ultrasound examination, magnetic resonance image (MRI) as well as CT of the thorax, etc.

Nine eyes of 5 patients with CM were examined. Unilateral choroidal involvement was present in 1 patient, bilateral in 4 cases. There were 1 case male and 4 case females. The age of these patients ranged from 31 to 56 years, median 45 years. Ocular symptoms included reduced vision in 4 patients and visual distortion in 1 patient. Visual acuity was 20/400- < 20/63 in four eyes; 20/63- < 20/30 in two eyes and >or= 20/30 in three eyes. The primary cancer site was in the lung in 3 patients, in the breast in 1 patient and in the stomach in 1 patient. Fundus characteristics: Typical CM was more often in the plateau-shaped than in the dome-shaped; yellow-white or mottled in color and associated with subretinal fluid and retinal detachment. The tumor was found in the macular area and juxtapapillary area in 6 eyes, in the area between the macula and the equator in 3 eyes. CM was solitary in 5 eyes and showed multiple lesions in 4 eyes. By FA the lesions showed mottled hyperfluorescence in early stage and leakage in late stage. By ICGA the lesion showed blocked fluorescence and hypofluorescence. Choroidal mass showed moderate irregular internal reflectivity in A-scan ultrasound. B-scan showed a plateau-shaped solid mass. MRI examination of the lesion revealed moderate short T1W and T2W signals. The cancer antigen increased to 16.28 and 4.95 microg/L in two cases. CA125 increased to 160.5 kU/L in one case.

The choroid is the most common site for metastases. CM may precede the diagnosis of primary tumor. Evaluation of A, B scan ultrasound, CT of thorax and cancer antigen test may be important to exclude primary carcinoma from lung and breast in patients with yellow-white in color, plateau-shaped choroidal lesions, especially in both eyes, and without known metastatic diseases.