Choroidal Metastasis

A patient presented to the Bascom Palmer Eye Institute with blurred vision in the left eye for 5 days. Past medical and ocular history was unremarkable. Past social history was notable for 25 pack-year smoking history. Visual acuity in the right eye was 20/20. Visual acuity in the left eye was 20/150. Intraocular pressure was normal in both eyes. Anterior segment exam was unremarkable in both eyes. Dilated fundus exam in the left eye was notable for a large creamy white choroidal lesion in the posterior pole superonasal to the optic nerve. EDI OCT of the lesion revealed a lumpy bumpy choroidal appearance with associated subretinal fluid. Given the concern for a choroidal metastasis, the patient underwent a systemic work up for cancer including a CT scan of the chest which revealed a primary lung cancer that was later confirmed on biopsy. The patient started local treatment with photodynamic therapy and systemic chemotherapy within 2-3 weeks of diagnosis. The visual acuity two months later improved to 20/30 in OS with complete resolution of the subretinal fluid on OCT.

Presentation Date: 02/29/2024

Issue Date: 03/08/2024