Frequency of ocular metastases in patients dying of cancer in eye bank populations

Abstract

Aims: To examine the frequency of intraocular metastases in patients who had died of cancer, in an eye bank and necropsy population sample.

Methods: The first group included 302 cancer cases received from the Wisconsin Eye Bank between 1988 and 1993. In the second group, ocular pathology records at the Wilmer Institute from 1976 to 1980 were analysed for ocular metastases in necropsy subjects dying of cancer. Nonocular cancer was the cause of death in 741 cases; among these, 510 were attributed to carcinomas.

Results: In the Wisconsin Eye Bank group, three cases (1%) had gross metastases. Out of 255 carcinoma cases, one (0.4%) had gross metastases. In the Wilmer Institute group, gross metastases were observed in 35 (4.7%) cases. Of the 510 patients dying of carcinomas, six (1.2%) had macroscopic metastases. Ocular metastases were detected histopathologically in 93 of 741 (12.6%) of cases.

Conclusion: Even though it is difficult to assess the true frequency of ocular metastases in patients dying of cancer, the answer to this question was attempted by determining the frequency of ocular metastasis in patients who died of cancer and who donated their eyes to the Wisconsin Eye Bank or had postmortem examination at the Johns Hopkins Hospital. Microscopic metastases were found in 12.6% of cases. The frequency of gross metastases has decreased over the past 12 years from 4.7% to 1% (p value = 0.005) owing to improved treatment of leukaemia; however, the frequency of macroscopic metastases due to carcinomas has not changed (p value = 0.38).