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Regression of Choroidal Metastasis From Breast Carcinoma Treated With Gamma Knife Radiosurgery

David R. Lally, MD1; Jay S. Duker, MD1; John E. Mignano, MD, PhD2; Stephen Martin, MD3; Andre J. Witkin, MD1
[+] Author Affiliations
1New England Eye Center, Tufts Medical Center, Boston, Massachusetts
2Department of Radiation Oncology, Tufts Medical Center, Boston, Massachusetts
3Department of Ophthalmology, The Aroostook Medical Center, Presque Isle, Maine
JAMA Ophthalmol. 2014;132(10):1248-1249. doi:10.1001/jamaophthalmol.2014.1974.
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Uveal metastasis is often managed by external beam radiation therapy requiring multiple treatment sessions for the patient. We report the first case, to our knowledge, of regression of choroidal metastasis from breast carcinoma after 1 treatment with Leksell Gamma Knife (GK) stereotactic radiosurgery.

Article InformationCorresponding Author: Andre J. Witkin, MD, New England Eye Center, Tufts Medical Center, 800 Washington St, PO Box 450, Boston, MA 02111 (ajwitkin@gmail.com).

Published Online: July 17, 2014. doi:10.1001/jamaophthalmol.2014.1974.

Author Contributions: Dr Witkin had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Lally, Duker, Witkin.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Lally, Witkin.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Lally.

Obtained funding: Duker, Witkin.

Administrative, technical, or material support: Lally, Duker, Mignano, Witkin.

Study supervision: Duker, Witkin.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was supported in part by an unrestricted grant to the New England Eye Center, Tufts University School of Medicine from Research to Prevent Blindness.

Role of the Sponsor: Research to Prevent Blindness was involved in the design and conduct of the study but had no role in the collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Figure 1.
Color Fundus Photograph Montage of the Left Eye Shows a Juxtapapillary 12 × 15-mm Amelanotic Choroidal Mass With Overlying Subretinal Fluid

Retinal pigment epithelial changes are seen along the inferior border of the lesion.

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Figure 2.
Color Fundus Photograph Montage of the Left Eye 1 Year After Treatment With Gamma Knife Radiosurgery

A flat chorioretinal scar with retinal pigment epithelial loss is observed. Two cotton-wool spots (arrowheads) are now evident in the macula at the border of the region of prior radiation treatment.

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