Symptomatic ocular metastases in lung cancer

Background and objective:   A survey was carried out of ocular manifestations of lung cancer.
Methods:   A retrospective analysis was performed of all lung cancer patients diagnosed between 1991 and 2005 at Taipei Veterans General Hospital, Taipei, Taiwan.
Results:   Sixteen lung cancer patients with symptomatic ocular metastases were identified. The incidence was less than 1%. The low incidence among these patients contrasts with previous reports of an incidence of about 6–7%, and suggests that most patients with ocular metastasis may be asymptomatic and remain undiagnosed. The most frequent ocular symptoms were changes in visual acuity. Metastases most frequently originated from adenocarcinomas and the choroids were the most common sites of metastases. Ten of the 16 ocular metastases were early events, identified prior to or at the initial diagnosis of the lung cancer. Only three of the 16 ocular metastatic events presented as solitary distant metastases.
Conclusion:   Although symptomatic ocular metastases are rare, they should be considered in lung cancer patients presenting with alterations in visual acuity.