ANALYSIS OF THE PREVALENCE OF METASTATIC CHOROIDAL LESIONS

Background: Ophthalmologists have a  low oncological vigilance, while oncologists are insufficiently aware of the incidence of choroidal metastases. Aim: To estimate incidence of choroidal metastases in Russia and to analyze prevalence of tumors metastasizing to the choroid. Materials and methods: Based on the literature, we empirically calculated the incidence of choroidal metastases in Russia. Our own study involved 70 patients (56  female and 14  male) with choroidal metastases. All patients underwent complete ophthalmic and physical examination. Results: In Russia, the estimated number of new choroid metastases cases in 2014 was 5561, which is 6-fold higher than the estimated number of primary uveal melanomas. Among 70  patients with choroidal metastases, the primary tumor site was known in 58  (82.8%) patients, whereas in 12 (17.2%) patients with choroidal metastases had an unknown primary tumor. The vast majority of primary tumors were carcinomas (53 patients, 91.4%); 4 patients (6.9%) had melanomas, and one (1.7%) had acute leukemia. Choroidal metastases were the first sign of advanced malignancy in 34 (48.6%) patients. The time periods from the date of diagnosis of the primary tumor to the date of diagnosis of intraocular metastatic tumors varied from  0 to 192  months. Conclusion: Empirical calculation shows that the incidence of choroidal metastasis in the adults is higher than that of the uveal melanoma. Due to the high prevalence of choroidal metastases, they should always be kept in mind if an intraocular neoplasm is detected. When choosing a diagnostic algorithm, special attention should be paid to the cancer history of the patient. The necessity of life-long ophthalmologic screening of patients with malignant neoplasms is hereby justified.

choroidal metastasis, metastatic lesion, metastases with unknown primary tumor