BLINDNESS OF TUMOR ORIGIN, WHAT ETIOLOGY SHOULD WE MENTION!

Ocular metastasis is rare. They represent 4 to 8% of secondary localization, essentially choroidal (88%), the pulmonary origin came in second line after breast as primary carcinoma, the prevalence of pulmonary ocular metastasis is estimated at 7.1% [1]Ocular metastasis is usually asymptomatic. Sometimes they cause a loss of visual acuity, metamorphopsia, phosphenes or eye pain, complete unilateral blindness, secondary to a metastatic localization on the macula. A total detachment of the retina is rarely reported.Ocular metastasis diagnosis is based on multiples modality, the ocular examination coupled to angiography, ocular sonography and MRI are the key diagnosis. Ultrasonography determines tumor allows differentiation of metastases from other intraocular neoplasms, particularly melanomas. They appear as a high echoic mass rarely cavitary variant has been describe 0.5% of choroidal metastasis present with a mushroom of collar-button aspect and the thickness is related to the origin in melanoma metastasis the measuring is 1 mm, breast 2 mm, lung and prostate 3 mm, and gastrointestinal and kidney measuring 4 mm. MRI often shows a well-demarcated choroidal mass that appears isointense on T1-weighted images and hypointense on T2-weighted images enhanced after gadolinium injection.[2]The differential diagnosis of ocular metastasis includes choroidal melanoma, hemangioma, granuloma, osteoma and sclerochoroidal calcification [2]Treatment is usually based on radiochemotherapy of the primary cancer. Treatment of symptomatic choroidal metastases should be conservative as long as possible to preserve quality of life in the short term. Hormonal therapy can be effective on hormone-sensitive cancers like breast and prostate.