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Ophthalmic Images |

Simultaneous Retinal and Choroidal Metastases in Lung Adenocarcinoma Online Only

Michael A. Klufas, MD1; Colin A. McCannel, MD1; Tara A. McCannel, MD, PhD1
[+] Author Affiliations
1Stein Eye Institute, Retina Division, University of California, Los Angeles
JAMA Ophthalmol. 2016;134(5):e155368. doi:10.1001/jamaophthalmol.2015.5368.
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This case report describes a woman in her seventies with a history of epidermal growth factor receptor–positive lung adenocarcinoma who presented with headache and decreased vision in the left eye.

A woman in her seventies with a history of epidermal growth factor receptor–positive lung adenocarcinoma, previously treated with chemotherapy and radiation, presented with a headache and decreased vision in the left eye. Snellen visual acuity was 20/30 in the left eye. Amsler grid testing results revealed metamorphopsia in the left central visual field. Ophthalmoscopy revealed 2 retinal lesions in the nasal macula and a choroidal mass in the temporal macula (Figure, A). Systemic workup revealed multifocal metastatic brain disease. A diagnosis of simultaneous retinal and choroidal metastases in a single eye owing to primary lung cancer was made.1,2 The patient underwent external beam radiation therapy to the brain and posterior globe of the left eye with complete regression of the retinal and choroidal lesions.

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A, Fundus photograph reveals 2 retinal lesions and a hypopigmented elevated choroidal mass in the macula. B, Fluorescein angiography shows filling of abnormal, saccular vessels in the area of the retinal metastases and staining of the temporal choroidal lesion.

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