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Management of patients with uveal metastases at the Liverpool Ocular Oncology Centre
  1. Lazaros Konstantinidis1,
  2. Iwona Rospond-Kubiak1,
  3. Ignacio Zeolite1,
  4. Heinrich Heimann1,
  5. Carl Groenewald1,
  6. Sarah E Coupland2,
  7. Bertil Damato3
  1. 1Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, UK
  2. 2Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK
  3. 3Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California San Francisco, USA
  1. Correspondence to Professor B Damato, Ocular Oncology Service, University of California, San Francisco, 10 Koret Way, K304, San Francisco, CA 94143-0730, USA; DamatoB{at}Vision.UCSF.edu

Abstract

Background Uveal metastasis is the most common intraocular malignancy.

Methods This was a retrospective study of all patients with uveal metastases referred to the Liverpool Ocular Oncology Centre between January 2007 and December 2012. Biopsy was performed as a primary investigation if the clinical examination suggested metastasis with no evidence of any extraocular metastases.

Results Ninety-six patients (109 eyes) were included. Breast and lung carcinomas were the most common primary malignancies, affecting 41 and 27 patients, respectively. The median time interval between detection of primary cancer and uveal metastasis was 24 months (range 1–288 months). Thirty-nine patients underwent ocular biopsy, confirming the diagnosis in all patients. The biopsy indicated the site of origin in 24 out of the 27 without a known primary tumour. In 7 of these 27 cases, previous systemic investigations had failed to identify the primary tumour. Seventy-three patients received external beam irradiation; two patients received photodynamic therapy; and two patients had Ru-106 plaque radiotherapy. The visual acuity was stable or improved in 75.5% of the cases.

Conclusions Immediate biopsy provides a quick diagnosis that may expedite treatment and improve any opportunities for conserving vision while facilitating the general oncologic management on these patients.

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