Choroidal metastases secondary to lung carcinoma: photo essay

Our second case is of a 40 year old male who presented with complaint of gradual diminution of vision RE for 1 month. He was known case of lung adenocarcinoma. He was under targeted chemotherapy. Vision in RE-5/60, LE-6/6. Intraocular pressure RE- 16, LE- 17 mm Hg on applanation tonometry. On examination of RE, anterior segment was within normal limits. RE Fundus evaluation revealed a bright yellow choroidal mass above the macula along the superotemporal arcade (Fig. 1c). There were mottled pigmentary changes over the macula. There was subretinal fluid over the macula which was confirmed on optical coherence tomography. USG B scan showed a dome shaped mass with medium internal reflectivity. He was diagnosed to have choroidal metastases secondary to lung adenocarcinoma. He was advised to continue the chemotherapy and to follow up after 1 month. After 1 month RE vision improved to 6/12. Fundus evaluation revealed complete regression of the choroidal mass with mottled retinal pigmentary changes (Fig. 1d).

This photo essay is presented to highlight the importance of thorough ocular examination to detect choroidal metastases in patients of lung cancer. If diagnosed early, targeted chemotherapy can lead to visual improvement with complete regression of ocular metastases.