SUBRETINAL ENDOSCOPIC SURGERY FOR METASTATIC CHOROIDAL TUMOR
Tatsushi Kaga1, Takashi Kojima2, Toshio Mori3
1Department of Ophthalmology, Japan Community HealthCare Organization, Chukyo Hospital, Nagoya, Japan.
Retinal Cases & Brief Reports
|May 20, 2021
Summary
Subretinal endoscopic surgery effectively treated a metastatic choroidal tumor, preserving visual function and improving prognosis. This innovative approach avoided enucleation and alleviated eye pain in a challenging case.
Area of Science:
- Ophthalmology
- Surgical Oncology
Background:
- Metastatic choroidal tumors can cause significant ocular morbidity, including pain and vision loss.
- Traditional treatments like chemotherapy and radiotherapy may be ineffective for ocular pain management in these cases.
Observation:
- A 68-year-old woman presented with a metastatic choroidal tumor and elevated intraocular pressure (54 mmHg), experiencing persistent eye pain despite systemic therapies.
- The tumor was associated with a complex retinal detachment adherent to the posterior lens surface.
Findings:
- Subretinal endoscopic surgery successfully removed the metastatic choroidal tumor and associated retinal detachment.
- Postoperatively, intraocular pressure normalized (7 mmHg), pain resolved, and the patient's survival prognosis improved from 3 to 18 months.
- At 21 months, the retina remained reattached with improved visual acuity (20/1,000) and controlled intraocular pressure (15 mmHg).
Implications:
- Subretinal endoscopic surgery offers a viable alternative for managing metastatic choroidal tumors, potentially preserving visual function and avoiding enucleation.
- This technique can lead to rapid symptomatic relief and improved long-term ocular health in select patients.
- Pathological findings guided subsequent systemic treatment modifications, enhancing overall patient management.
