Choroidal metastases: diagnosis and local treatments (a systematic review)

Abstract

Objetives: To carry out a systematic review on diagnostic methods and local treatments for the treatment of choroidal metastasis
Material and methods: A systematic search was carried out following the PRISMA recommendations using Pubmed and Embase databases, of articles published up to June 2020. The keywords used were: “choroidal metastasis”, “treatment of choroidal metastasis”, “Diagnostic choroidal metastasis”, “treatment of choroidal metastases”, “external beam radiation therapy”, “proton beam therapy”, “transpupillary thermotherapy”, “photodynamic therapy” and “intravitreal injection”. Inclusion criteria: cohort studies and case series without limit by number of without limit by number of eyes, with patients with a diagnosis of choroidal metastases and complete documentation of the disease. Duplicate and incomplete studies were excluded.
Results: A total of 245 articles were found both in the combined and directed searches, of which 7 were used to analyze the diagnostic characteristics and 17 to analyze the types of local treatments. Regarding diagnostic methods, articles published between 1985 and 2014 were included, 100% were retrospective cohort studies or case series. The studies referring to local treatments were published between 1977 and 2016, most of the studies were interventional retrospective case series, case series and case reports.
Conclusions: Despite the improvement in diagnostic methods, the diagnosis remains clinical. A great variety of types of local treatments are described, however, there are no treatment algorithms to date and the treatments must be individualized.