{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:22:24Z","timestamp":1787840544147,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"Abstract<\/jats:title>\n \n Purpose:<\/jats:title>\n To report the first documented case of progression from bilateral unifocal to multifocal choroidal metastases in a patient with previously undiagnosed lung cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A single case report illustrated with multimodal imaging.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A 53-year-old Caucasian male presented with a drop of vision to 20\/80 associated with a hyperopic shift from \u22123.0 to +3.5 diopters in the right eye. Fundus examination revealed subretinal hemorrhages and retinal stress lines caused by a large, creamy subfoveal mass in the right eye, in addition to a smaller, yellow, and asymptomatic lesion located temporal to the fovea in the left eye. A red-free image demonstrated retinal stress lines. Autofluorescence illustrated central hypoautofluorescence surrounded by hyperautofluorescence, while angiography exhibited central hypofluorescence with surrounding progressive hyperfluorescence. Optical coherence tomography exhibited dome-shaped lesions with thickening of the retinal pigment epithelium and choroid, accompanied by subretinal hyperreflective infiltration. Ultrasound examination depicted two choroidal lesions with medium-to-low reflectivity. A subsequent systemic evaluation by an oncologist confirmed primary lung cancer with metastases. An examination 8 weeks later revealed counting fingers in the right eye and 20\/30 in the left eye, accompanied by the appearance of multiple new metastases in both eyes and an extensive serous retinal detachment with increased density of hyperreflective speckles.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Early ophthalmologic signs may lead to the diagnosis of systemic cancer. A multimodal imaging approach enhances the interpretation of clinical features by providing a comprehensive view of the pathological changes in choroidal metastases.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joco.joco_184_25","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:02:46Z","timestamp":1773824566000},"page":"363-367","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Progression from Bilateral Unifocal to Multifocal Choroidal Metastases: A Multimodal Imaging Case Report of Undiagnosed Lung Cancer"],"prefix":"10.4103","volume":"37","author":[{"given":"Bilal","family":"Haj Najeeb","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Dean","family":"Bawarish","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Dunavoelgyi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Schmidt-Erfurth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sacu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"R1-20260319","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/S0161-6420(97)30148-1","article-title":"Survey of 520 eyes with uveal metastases","volume":"104","author":"Shields","year":"1997","journal-title":"Ophthalmology"},{"key":"R2-20260319","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1016\/S0161-6420(79)35393-3","article-title":"Diagnosis and management of cancer metastatic to the uvea: A study of 70 cases","volume":"86","author":"Stephens","year":"1979","journal-title":"Ophthalmology"},{"key":"R3-20260319","doi-asserted-by":"crossref","first-page":"e0249210","DOI":"10.1371\/journal.pone.0249210","article-title":"Clinical and ultrasonographic features of choroidal metastases based on primary cancer site: Long-term experience in a single center","volume":"16","author":"Blasi","year":"2021","journal-title":"PLoS One"},{"key":"R4-20260319","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/j.1600-0420.2007.01081.x","article-title":"Incidence and clinical characteristics of symptomatic choroidal metastasis from lung cancer","volume":"86","author":"Kreusel","year":"2008","journal-title":"Acta Ophthalmol"},{"key":"R5-20260319","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.ophtha.2013.07.014","article-title":"Uveal metastasis from lung cancer: Clinical features, treatment, and outcome in 194 patients","volume":"121","author":"Shah","year":"2014","journal-title":"Ophthalmology"},{"key":"R6-20260319","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1001\/archopht.1987.01060090073031","article-title":"Metastatic tumors to the eye and orbit. Patient survival and clinical characteristics","volume":"105","author":"Freedman","year":"1987","journal-title":"Arch Ophthalmol"},{"key":"R7-20260319","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1159\/000366559","article-title":"Spontaneous necrosis of choroidal melanoma","volume":"1","author":"Thareja","year":"2014","journal-title":"Ocul Oncol Pathol"},{"key":"R8-20260319","doi-asserted-by":"crossref","first-page":"406","DOI":"10.3928\/15428877-20100426-03","article-title":"Choroidal metastases fundus autofluorescence imaging: Correlation to clinical, OCT, and fluorescein angiographic findings","volume":"41","author":"Natesh","year":"2010","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"R9-20260319","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1097\/IAE.0000000000000083","article-title":"Enhanced depth imaging optical coherence tomography of choroidal metastasis","volume":"34","author":"Demirci","year":"2014","journal-title":"Retina"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_184_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:44Z","timestamp":1787837084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_184_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_184_25","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-06-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}