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Cancers Affecting the Retina

By

Sonia Mehta

, MD, Vitreoretinal Diseases and Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Jun 2020| Content last modified Jun 2020
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Topic Resources

The retina is the transparent, light-sensitive structure at the back of the eye. Cancers affecting the retina usually occur in the choroid, a dense layer of blood vessels that supplies the retina. The choroid is sandwiched between the retina and the sclera (the outer white layer of the eye). Because the retina depends on the choroid for its support and half of its blood supply, damage to the choroid by a cancer is likely to affect vision.

Choroidal melanoma

Choroidal melanoma is a cancer that originates from the pigment-producing cells (melanocytes) of the choroid. Choroidal melanoma is the most common cancer originating in the eye. It is most common among whites. It occurs most frequently at age 55 to 60.

Symptoms

In its early stages, the cancer usually does not interfere with vision. Later, it may cause blurred vision or retinal detachment, with symptoms such as flashes of light, a veil or curtain across the visual field, or a sudden increase or change in floaters (objects that appear to move through a person's field of vision). Melanomas, particularly if large, may extend into the orbit or spread through the bloodstream (metastasize) to other parts of the body and may be fatal.

Diagnosis

Treatment

  • For small tumors, laser, radiation, or an implant

  • For large tumors, removal of the eye

If the melanoma is small, treatment with a laser, radiation, or an implant of radioactive materials may preserve vision and save the eye.

If the cancer is large, the eye may have to be removed.

Choroidal metastases

Choroidal metastases are cancers that have spread to the choroid from other parts of the body. Because of its rich blood supply, the choroid is often a place to which cancers from other parts of the body may spread. In women, breast cancer is the most common cause. In men, cancers of the lung and prostate are the most common causes.

Symptoms

Often, choroidal metastases cause no symptoms until they are advanced. Symptoms, when they develop, are often loss of vision or symptoms of detachment of the retina Detachment of the Retina Detachment of the retina is separation of the retina (the transparent, light-sensitive structure at the back of the eye) from the underlying layer to which it is attached. People notice a sudden... read more such as floaters, flashes of light, blurred vision, and a veil or curtain across the field of vision. Vision loss can range from mild to severe.

Diagnosis

  • A doctor's examination of the eye

  • Usually ultrasonography

  • Biopsy

Confirmation of the diagnosis may involve using a fine needle to remove a sample of tissue for examination under a microscope (biopsy).

Treatment

  • Chemotherapy and/or radiation therapy

Treatment of choroidal metastases depends on the primary cancer and is usually with chemotherapy, radiation therapy, or both.

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Test your knowledge

Eye Redness
Eye redness is a condition in which the part of the eye that is normally white appears reddish. This occurs when blood vessels on the surface of the eye widen (dilate), bringing extra blood to the eye. Which of the following is NOT a frequent cause of eye redness? 
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