Frequency and Patterns of Underlying Malignancies in Choroidal Metastases: A 10-Year Cross-Sectional Study in an Iranian Population

Author(s): Ayat Ahifar, Nastaran khodakarim, Masood Naseripour, Ahad sedaghat, Fatemeh Tajik Rostami, Amineh Salem, Ramin Ajami

Introduction: Choroidal metastases are commonly diagnosed alongside other metastatic lesions, with 67%–88% of patients presenting metastases in other parts of the body. This study aimed to assess the frequency and patterns of underlying malignancies in patients diagnosed with choroidal metastases and to explore potential associations based on the Iranian population's genetic and lifestyle factors. Methods: This cross-sectional study was conducted at Rasool Akram Hospital, Tehran, between 2011 and 2021. Data were collected from patients diagnosed with choroidal metastases, including those with previously known underlying malignancies and those diagnosed after ophthalmological evaluation. Patients with melanoma were excluded. Statistical analysis was performed using the chi-square test, Fisher’s exact test, Student’s t-test, or Mann–Whitney U test, with a significance level set at p < 0.05. Results: A total of 52 patients were included (37 women [71.15%] and 15 men [28.85%]), with a mean age of 54.13 ± 13.91 years. The most frequent underlying malignancies were breast cancer (24 patients, 46.2%) and lung cancer (7 patients, 13.5%), while 12 cases (23.1%) patients had an unknown primary malignancy. Bilateral ocular involvement was observed in 11 patients (21.2%). A significant association was found between female gender and breast cancer (p < 0.001) and between male gender and lung cancer (p = 0.03). Positive subretinal fluid (SRF) was identified in 67.35% of cases. Chemotherapy was the most frequently used treatment modality (p = 0.01). Conclusions: This study underscores the need for regular ocular screening in patients with advanced breast and lung cancers. Significant gender-based associations in choroidal metastases highlight the importance of targeted screening and treatment strategies.