Background: Choroidal metastases generally respond well to radiation treatment. However, a deterioration of visual acuity after radiation must be taken into account in lesions involving the optic nerve. In these cases, alternatives to radiation, which is a palliative treatment in most cases anyway, should be considered.
Material and methods: We present the clinical and echographic findings of a case of a 39-year-old patient with choroidal metastasis from breast carcinoma.
Results: We observed a regression of the metastasis and an improvement of visual acuity from 0.2 to 1.0 under systemic chemotherapy. Echography showed a decrease of tumor height and increasing reflectivity indicating progressive scarring of the lesion. Up to now, the patient has survived 9 years after initial diagnosis.
Conclusions: Especially in cases in which a deterioration of visual acuity after radiation must be expected, the follow-up during systemic chemotherapy alone might be considered an alternative option, as it not only might preserve vision, but also allows an "in vivo" monitoring of the success of the chemotherapy applied.