Isolated metastases to the retina or optic nerve

Area of Science:

• Ophthalmology
• Oncology

Background:

• Isolated metastases to the retina or optic nerve are rare occurrences.
• These metastases can originate from various primary cancers, including melanoma and carcinomas.

Purpose of the Study:

• To review the clinical presentation, diagnostic methods, and treatment outcomes for rare cases of isolated retinal and optic nerve metastases.

Main Methods:

• Review of clinical presentations and outcomes based on existing literature.
• Analysis of metastasis origin (melanoma vs. carcinoma) and its clinical appearance.
• Evaluation of diagnostic workup, including cytological examination.
• Assessment of treatment modalities and their impact on prognosis.

Main Results:

• Retinal metastases commonly arise from cutaneous malignant melanoma and carcinomas, presenting with vision loss.
• Optic nerve metastases originate from carcinomas and leukemias, also causing vision reduction.
• Metastases appear brown/black for melanoma and white for carcinoma, often accompanied by hemorrhages and exudates.
• Visual prognosis is generally poor, with a median survival of approximately 9 months.

Conclusions:

• Early detection and appropriate management are crucial for patients with ocular metastases.
• Treatment strategies range from observation to radiotherapy and enucleation, depending on visual potential and pain.
• Breast carcinoma as a primary lesion may offer a slightly better survival outcome.