RESUMEN
La coroides es el tejido ocular más comúnmente afectado por la enfermedad metastásica debido a su abundante vascularización y, en ocasiones, la primera manifestación (44-70% según las series) de cáncer de pulmón en hombres o de cáncer de mama en mujeres (3%). Síntomas oculares de inicio abrupto en pacientes jóvenes y signos al examen oftalmológico como engrosamiento de la pared posterior o lumpy-bumpy surface, entre otros, son orientativos. La uveítis anterior granulomatosa, la uveítis intermedia bilateral, la panuveitis bilateral o las lesiones granulomatosas a nivel coroideo o del nervio óptico se consideran indicativas de sarcoidosis en presencia de un cuadro radiológico compatible. Estas pueden preceder a los signos sistémicos en un 30% de los casos. Se presentan tres pacientes con signos y síntomas oftalmológicos que precedieron al diagnóstico de enfermedades sistémicas no infecciosas.
The choroid is the ocular tissue most commonly affected by metastatic disease due to its abundant vascularization and is sometimes the first manifestation (44-70% depending on the series) of lung cancer in men or breast cancer in women (3%). Abrupt-onset ocular symptoms in young patients and signs on ophthalmological examination such as thickening of the posterior wall, "lumpy-bumpy surface", among others, are indicative. Granulomatous anterior uveitis, bilateral intermediate uveitis, bilateral panuveitis or granulomatous lesions at the choroidal or optic nerve level are considered indicative of sarcoidosis in the presence of a compatible radiological picture. These may precede systemic signs in 30% of cases. We present 3 patients with ophthalmological signs and symptoms that preceded the diagnosis of non-infectious systemic diseases.
RESUMEN
Objective To study the occurrence,diagnosis and treatment of uveal metastasis in patients with breast cancer.Methods In 2400 cases of breast cancer patients,2 cases of uveal metastasis admitted from Jan.2007 to Aug.2011 in our hospital were retrospectively analyzed to study the occurrence,diagnosis and treatment.Results Both the 2 cases had the symptoms of blurred vision and hypopsia.Fundus examination and funds fluorescein angiography showed that the 2 cases had unilateral choroidal metastasis with the discovery rate of 0.08％.Case 1 was found to have uveal metastasis before breast cancer was confirmed and case 2 was found to have uveal metastasis during the 4th chemotherapy cycle.No other distant metastasis was found in these 2 patients.The eye symptoms improved obviously after chemotherapy.Conclusions In order to get a good therapeutic effect for breast cancer patients with uveal metastasis,we should pay attention to patients' symptoms and signs.Eyes examination should be taken when patients have eye symptoms and signs.