Brazilian retrospective study finds frequency of ocular metastases relatively low

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Brazilian investigators concerned about the occurrence of ocular metastases conducted a retrospective study and found that the frequency of ocular metastases was relatively low, according to first author Matheus Senna Pereira Ogata, MD.¹ He and his colleagues are from the Department of Ophthalmology and Visual Sciences, Paulista Medical School, Federal University of São Paulo, São Paulo, Brazil.

Considering what is known about ocular metastases, ie, that they are the most common intraocular tumors in adults,² they might be one of the first signs of disseminated disease,³ and these cases are typically associated with a poor systemic prognosis,⁴ the investigators investigated the profile of patients with ocular metastases in an attempt to expand the knowledge base.

All patients included in the study had been referred to Ocular Oncology Service of the Federal University of São Paulo with the suspicion of ocular metastasis.

The medical records from June 2017 to June 2023 were searched for patient data. The investigators collected the following data: Age, sex, primary tumor site, previous knowledge of the systemic diagnosis, laterality, initial visual acuity (VA), local or systemic treatment, and mean follow-up period.

Ogata and colleagues identified 37 cases (mean age at diagnosis, 53.47 years) that had been referred to the Ocular Oncology division because of suspected ocular metastasis, of which 15 (40.5%) were confirmed. Almost three-quarters of patients, 73.3%, were women.

Most patients (86.7%) knew the systemic diagnosis. The most common primary tumor sites were the breast in 66.7% and the lungs in 26.7% of cases.

The investigators reported, “Both eyes were affected in 66.67% of the cases, all patients had metastases at the choroid (100.0%), and the mean initial VA was 1.37 ± 1.04 logarithm of the minimum angle of resolution.”

The primary systemic treatment was chemotherapy in 73.3%. Most patients, 53.3%, did not undergo ocular treatment. Patients were followed for a mean of 14.8 months. The mortality rate during the follow-up period was 30.0%.

Considering the number of new patients absorbed by the Ocular Oncology service over the study period, the frequency of ocular metastases was relatively low. The patients’ characteristics were comparable to data published in the international literature, the investigators reported.

In commenting on this first such study in a Brazilian population, the authors said, “Our findings described the profile of patients with a confirmed diagnosis of metastases in Brazil presenting individuals and lesions characteristics. Most cases did not have any ocular treatment and the mortality rates were considerably low. Multicentric studies are recommended to better characterize this population.”

References:

1. Ogata MSP, Ferreira GR, Morales MC, Fernandes AG. Ocular metastases profile in a tertiary hospital in São Paulo, Brazil. Int J Retin Vitr. 2024;10:34; https://doi.org/10.1186/s40942-024-00551-7

2. Shields CL, Shields JA, Gross NE, Schwartz GP, Lally SE. Survey of 520 eyes with uveal metastases. Ophthalmology. 1997;104:1265–76.

3. Eliassi-Rad B, Albert DM, Green WR. Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol. 1996;80:125–8.

4. Shields JA, Carvalho C, Shields CL, Singh AD, Wagner D. Bilateral choroidal metastasis from adenoid cystic carcinoma of the submandibular gland. Retina. 2000;20:406–7.