Early detection, comanagement necessary for ODs treating cancer patients
PHILADELPHIA – The author of a poster presented at Optometry's Meeting recommended that optometrists work as part of a team when dealing with cancers that metastasize to the eyes.
Essence N. Robinson, OD, FAAO, of Texas State Optical in Beaumont, Texas, evaluated the case of a 53-year-old woman who came to her office with central dimness and blurriness in her right eye, according to the poster.
The author noted that the patient had been diagnosed with breast cancer in 1998 and had been treated with a lumpectomy of the left breast with left axillary dissection, a total hysterectomy in 2005, chemotherapy and oral treatment with tamoxifen, Arimidex (anastrozole, AstraZeneca) and later Femara (letrozole, Novartis) until 2011.
Through several retinal consults, it was determined that the patient likely had a choroidal metastasis. After an oncology consult, imaging showed bony metastatic disease in the sternum, right rib, vertebral column and bilateral hips, the poster detailed.
"Imaging plays a central role for the diagnosis and treatment of metastatic tumors," the author said in the poster.
The author recommended utilizing ultrasound, fluorescein angiography and optical coherence tomography.
“Breast cancer metastasis can take place 10 years or even longer after the original treatment,” Robinson noted. “According to the American Academy of Ophthalmology, metastases to the eye are being diagnosed with increasing frequency due to: increasing incidence of certain eye tumor types that metastasize to the eye; prolonged survival of patients with certain cancer types; and increasing awareness among medical oncologists, ophthalmologists and optometrists of the pattern of metastatic disease.
“Not every patient will present at the earliest onset of their symptoms or be forthcoming with all of their medical history,” Robinson concluded. “A thorough history, in addition to further imaging, helps assist in confirming a diagnosis of a choroidal metastasis. Early detection, referrals and comanagement help in saving one’s eye physically and functionally, as well as discovering additional sites of metastasis that can be treated early in hopes for a better quality of life and prolonged survival.” – by Chelsea Frajerman
Disclosure: The author has no relevant financial disclosures.