Diagnosis of choroidal metastasis.

In a retrospective study we examined the files of 47 patients with choroidal metastasis (56 eyes of 18 male and of 29 female patients, ranging from 29 to 85 years of age). Primary breast carcinoma is the tumour most frequently responsible for choroidal metastasis (55% of the cases). Lung cancer (13% of the cases) is the most common primary tumour in males. No primary site was found in 10% of the cases. The period between the diagnosis of the primary tumour and the onset of choroidal metastasis is clearly shorter in lung cancer than in breast cancer. Furthermore, in the latter, generalized metastasis is often already known. Choroidal metastasis develops preferentially in the posterior pole. There is no preponderance of left-side involvement. It mostly concerns a solitary tumour, although multiple foci, in one or both eyes, are found in 21% of the patients. Fluoroangiography shows different patterns, but this method is not specific enough to allow differentiation from other choroidal tumours. Diagnosis is mainly supported by history, clinical context and echography.