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ISSN: 2155-9570
Journal of Clinical & Experimental Ophthalmology
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Choroidal Metastases from Breast Cancer

Shota Fujii* and Naoki Horiuchi
Keio University School of Medicine, Tokyo, Japan
Corresponding Author : Shota Fujii MD
Department of Ophthalmology
Keio University School of Medicine
Tokyo, Japan
Tel: +81-3-3353-1211
E-mail: [email protected]
Received: September 05, 2014; Accepted: October 14, 2014; Published: October 17, 2014
Citation: Fujii S, Horiuchi N (2014) Choroidal Metastases from Breast Cancer . J Clin Exp Ophthalmol 5:362. doi:10.4172/2155-9570.1000362
Copyright: © 2014 Fujii S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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Abstract

A 65-year-old woman presented with a one-month history of impaired vision in the right eye. She had undergone a surgery for breast cancer 8 years prior to the vision loss. On examination, her best spectacle-corrected visual acuity was 20/40 Snellen in the right eye and 20/20 in the left eye. Fundus photograph displayed a large choroidal tumor at inferior area. The vision loss was due to the tumor, which involved the macula. A CT scan revealed metastatic choroidal tumors in her both eyes and the other metastasis was not detected. She decided to receive a horomone therapy and a radiation therapy. Brest caners often spread to choroid as well as brain, as choroid is filled with blood vessels.

Abstract

A 65-year-old woman presented with a one-month history of impaired vision in the right eye. She had undergone a surgery for breast cancer 8 years prior to the vision loss. On examination, her best spectacle-corrected visual acuity was 20/40 Snellen in the right eye and 20/20 in the left eye. Fundus photograph displayed a large choroidal tumor at inferior area. The vision loss was due to the tumor, which involved the macula. A CT scan revealed metastatic choroidal tumors in her both eyes and the other metastasis was not detected. She decided to receive a horomone therapy and a radiation therapy. Brest caners often spread to choroid as well as brain, as choroid is filled with blood vessels.
 
Keywords

Choroidal metastasis; Breast cancer
 
Case Report

A 65-year-old woman presented with a one-month history of impaired vision in the right eye. She had undergone a surgery for breast cancer 8 years prior to the vision loss. The breast cancer was an invasive ductal carcinoma and had not spread to the other organs. On examination, her best spectacle-corrected visual acuity (BSCVA) was 20/40 Snellen in the right eye and 20/20 in the left eye. Fundus photograph of the right eye displayed a large choroidal tumor, which involved the macula (Figure 1).

Fundus photograph of the left eye showed 2 choroidal tumors, which separated from the macula (Figure 2).

Computerized tomography (CT) revealed choroidal tumors in the both eyes, but other metastases were not detected. We diagnosed the tumors as choroidal metastases from breast cancer, because the tumors grew in both eyes, did not have calcification on CT image, and were yellowish white dome-shaped, which were common findings of metastatic choroidal tumors. She decided to receive a hormone therapy and a radiation therapy for the both eyes. She was followed for 6 months. The tumor in the right eye have increased in size, and moreover, severe retinal detachment caused to lose her eyesight; BSCVA was light perception (Figure 3). As the tumors in the left eye has been almost stable, she has kept good visual acuity of the left eye; BSCVA was 20/20 (Figure 4). Other metastases have not been found. If the choroidal tumors in the left eye enlarge to involve the macula in spite of the conventional treatments, we will consider an option of intravitreal bevacizumab injection, which is reported to be less invasive and effective to decrease subretinal fluid [1].

Breast cancers often spread to choroid as well as brain, as choroid is filled with blood vessels. Choroidal metastasis from breast cancer possibly occurs many years after breast cancer surgery [2,3]. It is important to pay attention to breast cancer patients with ocular symptoms, such as decreased vision or metamorphopsia.
 
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