Younger age and systemic metastases may independently predict survival among patients with choroidal metastases

1. Younger age (<59.6 years) and systemic metastases (>1) were independent predictors of survival among patients with choroidal metastases.

Evidence Rating Level: 2 (Good)

Around 1–2% of all cancer patients develop intraocular metastases, with the choroid representing the primary site of metastatic involvement (90%). It is unclear how age and primary tumor type impact survival in choroidal metastasis. This study investigated the association of patient’s age and primary tumor type with survival following choroidal metastasis diagnosis. This retrospective study included patients diagnosed with choroidal metastases between August 2013 and July 2025. Patients were grouped according to primary tumor origin (lung, breast, or other primaries) and age at time of choroidal metastasis diagnosis (<59.6 vs ≥59.6 years). In total, 70 patients and 70 eyes were included in the study (mean [SD] age = 57.54 [13.02], female [%] = 43 [61.4%]). The median overall survival was 71.6 weeks. Patients <59.6 years survived significantly longer than patients ≥59.6 years (median 88.3 vs 41.9 weeks; estimated 3-year survival 33.2% vs 16.8%; p = 0.037). The median survival based on primary tumor group was 94.4 weeks for breast cancer (estimated 3-year survival 38.3%), 52.7 weeks for lung cancer (9.5%), and 40.6 weeks for other primaries (19.7%), but these differences were not statistically significant (p = 0.269). Patients aged ≥59.6 years had a 2.1-fold higher hazard of death compared with those < 59.6 years (HR = 2.10; p = 0.016). Patients with >1 metastasis elsewhere in the body had a 2.53-fold higher risk for mortality compared to those with one or no metastases (HR = 2.53; p = 0.029). Primary tumor classification (lung, breast, others) was not significantly associated with survival (p = 0.088). Overall, this study found that younger age (<59.6 years) and systemic metastases (>1) were independent predictors of survival among patients with choroidal metastases, supporting their use as reliable indicators for a more favourable prognosis.

Click here to read this study in PLOS One

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