First Author: Y.Kirilova BULGARIA
Co Author(s): H. Krasteva P. Vassileva
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To discuss problems of diagnosis and treatment in patients with ocular metastases.
University Eye Hospital “Prof. Pashev”
We present tree patients - two men and one woman (aged 43y, 65y and 69y) with ocular metastases in the choroid (two patients) and in the iris (one patient). Full ophthalmological examination with fotodocumentation was perfomed and additional specialized investigations such as: ultrasonography, chest radiography, MRI, CAT, PET and PSA (in men) were done.
The female patient had surgery for breast carcinoma 7years ago, with no metastases at the moment of ocular examination. We found a pale, prominent tumour mass in the fundus, suspicious for granulomatous uveitis. The serology test for tuberculosis was positive, so we started an antibiotic treatment. Few months late metastases in brain and bones were found in PET scan examination. In the two men the cancer was diagnosed due to the ocular metastases. One patient with iris nodule was treated for iridocyclitis. The physical condition of the patient deteriorated because of advanced prostate adenocarcinoma with multiple metastases. The last patient was diagnosed with retinal detachment. We established multiple pale lesions with exudative retinal detachment.The patient was referred to oncologist and two different cancer (prosate and lung) were diagnosed. Biopsy from liver metastasis proved metastatic disease from lung carcinoma.
Ocular metastases are important problem in ophthalmology and they can be mistaken for chronic uveitis. However the patients don't have any complains and few of them come for ocular exam on time. Early detection, diagnosis and treatment offers the best chance to preserve patient life.