Optical coherence tomography for retinal metastasis with unknown primary tumor

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Metastatic neoplastic disease of the retina is rare.
• Diagnosis can be challenging, requiring advanced imaging and biopsy techniques.

Observation:

• A patient with a history of brain cancer presented with a suspected metastatic retinal lesion.
• Optical coherence tomography (OCT) revealed retinal thinning and distinctive cordon-like hyperreflective structures.
• The patient underwent imaging and surgical investigation of the right eye.

Findings:

• Vitreous biopsy identified neoplastic cells consistent with small cell carcinoma.
• The identified cells were morphologically similar to the patient's previously biopsied cerebellar tumor.
• OCT findings correlated with the presence of metastatic disease.

Implications:

• OCT imaging is a valuable tool for evaluating suspected metastatic lesions in the retina.
• Combined approach of OCT, vitrectomy, and retinal biopsy aids in diagnosing retinal metastases.
• This case highlights the importance of considering ocular metastases in patients with a history of cancer.