Dr. Prajakta Patil(Fellow), Dr. Sarvesh Tiwari(Consultant), Dr. Gaurav Shah(Honorary Consultant), Dr. Anand Subramanyam (Head Of The Department), K. B. H. Bachooali Ophthalmic And Ent Hospital,Parel,Mumbai

1. OCT : Noninvasive method to
monitor effectivity of chemotherapy
in lung carcinoma.
DR PRAJAKTA PATIL(Fellow)
DR SARVESH TIWARI(Consultant)
DR GAURAV SHAH(Honorary Consultant)
DR ANAND SUBRAMANYAM(Head of the Department)
K B H Bachooali Ophthalmic and ENT Hospital,Parel,Mumbai

2. PURPOSE
• To evaluate the role of OCT in a patient with
choroidal metastasis who has been treated
with chemotherapy and external beam
radiotherapy

3. MATERIALS AND METHODS
• 63 years old male
• k/c/o primary adenocarcinoma of lung
• On chemotherapy (3 cycles completed) and EBRT
( 1 session completed)
• c/o DOV (OD) since 3 months
• BCVA (OD) CF ½ meter, (OS) 6/6

4. (OD)Multiple elevated cream- yellow
coloured mass lesions involving
choroid in superotemporal quadrant
(1) Neurosensory RD
(2) Highly reflective lesions overlying
the RPE–choriocapillaris
complex,subretinal space ,along
inferior margin of retina.

5. After 4 cycles of chemotherapy
(OD) BCVA CF 1 meter
Size and height of choroidal
lesions decreased
Subretinal fluid decreased
Hyper reflective lesions in subretinal
Space, overlying RPE choriocapillay
complex persisting

6. After 4 cycles of chemotherapy and 3
cycles of maintenance therapy
(OD) BCVA 6/24
Choroidal lesions flattened
Macular contour regained with
disappearence of hyper reflective
lesions

7. Discussion
• Choroidal metastasis is the most frequent
ocular tumor.1,2
• The most frequent primary tumors in
choroidal metastases are located in the lung
and the mammary glands 3
(1)Duke JR, Walsh FB. Metastatic carcinoma to the retina. Am J Ophthalmol 1959;47:44 – 8. 4.
(2) Koenig RP, Johnson DL, Monahan RH. Bronchogenic carcinoma with metastases to the retina. Am J Ophthalmol 1963; 56:827–9
(3) Barak A, Neudorfer M, Heilweil G, Merimsky O, Lowenstein A, Inbar M, et al. Decreased prevalence of asymptomatic choroidal metastasis
in disseminated breast and lung cancer: argument against screening. Br J Ophthalmol 2007; 91: 74-75

8. • Metastatic cancer to the uvea and optic disc
involves the posterior pole in 40% of cases.
Shields JA, Shields CL. Intraocular Tumors: A Text and Atlas. Philadelphia: WB Saunders; 1992:207–38

9. Our patient had following OCT features :
(1) Neurosensory RD
(2) Highly reflective lesions overlying the RPE–
choriocapillaris complex
(3) Highly reflective points in the subretinal
space
Arevalo, J.F., Fernandez, C.F., and Garcia, R.A. Optical coherence tomography characteristics of choroidal
metastasis. Ophthalmology. 2005; 112: 1612–1619

10. After chemotherapy, OCT of our case showed
improvement of the serous RD and reduction of
the lesion’s size, with recovery of the normal
retinal architecture

11. Conclusion
• OCT is a useful imaging technique to study
choroidal metastatic tumors.
• Optical coherence tomography in patients with
choroidal metastasis demonstrates the secondary
retina–RPE changes
• OCT can be used as noninvasive method to
monitor the effectivity of chemotherapy in
choroidal metastasis involving posterior pole