Intraocular and Ocular Adnexal Metastases: A Comprehensive Review.

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Ocular metastases, though rare, are critical indicators of systemic malignancy, sometimes being the initial sign of cancer.
• Breast and lung carcinomas are the most frequent primary sources, followed by kidney, gastrointestinal tract, and cutaneous melanomas.
• The choroid is the most common intraocular site due to its extensive vascular supply.

Purpose of the Study:

• To provide a comprehensive review of the epidemiology, clinical features, diagnosis, and management of ocular metastases.
• To highlight the importance of early recognition and multidisciplinary approaches in managing these conditions.
• To discuss the impact of emerging diagnostic and therapeutic modalities on patient outcomes.

Main Methods:

• Review of existing literature on ocular metastases, covering epidemiology, clinical presentation, diagnostic techniques, and treatment strategies.
• Analysis of tumor spread mechanisms, primarily hematogenous, and factors influencing organ predilection.
• Evaluation of current and emerging therapeutic options, including systemic and local treatments.

Main Results:

• Choroidal metastases are the most frequent intraocular presentation, while orbital sites are most common for adnexal involvement.
• Ophthalmic multimodal imaging and intraocular biopsy enhance early detection.
• Systemic chemotherapy and radiotherapy are standard, with immunotherapy and targeted therapies revolutionizing management.

Conclusions:

• Ocular metastases necessitate prompt recognition as they can precede primary cancer diagnosis.
• Early detection via clinical evaluation and advanced imaging is crucial for timely intervention.
• Novel therapies offer promise for improving quality of life and survival, emphasizing the need for collaborative research and multidisciplinary care.