Isolated metastases to the retina or optic nerve. 1997

H G Mack, and F A Jakobiec
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114, USA.

Isolated metastases to the retina or optic nerve are extremely rare. Retinal metastases arise from cutaneous malignant melanoma and carcinomas (lung, gastrointestinal, genitourinary, and breast). Most patients present with reduced vision. The clinical appearance of these metastases is variable. Melanoma metastases are brown or black, whereas carcinoma metastases are white. Frequently, retinal hemorrhages and exudates are seen. Optic nerve metastases arise from carcinomas (lung, breast, and gastrointestinal) in adults and acute leukemias in children. As is true of retinal metastases, most patients present with reduced vision. Though in most cases there is a visible optic nerve mass, some patients have optic disc edema only. Investigations are directed by a known history of malignancy in many patients and by physical examination. Cytological workup of vitreous may be required. Treatment options include observation, radiotherapy in eyes with visual potential, and enucleation for pain control. The visual prognosis is poor. In patients with retinal or optic nerve metastases, median survival is approximately 9 months after the onset of visual symptoms, but is slightly longer in cases in which the primary lesion is breast carcinoma.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009369 Neoplasms New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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