bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2025-4-2-22-31bmjour-290Research ArticleНаучные обзоры литературыScientific literature reviewsМЕТАСТАТИЧЕСКОЕ ПОРАЖЕНИЕ ОРГАНОВ ЗРЕНИЯ ПРИ РАКЕ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫUVEAL METASTASIS FROM PROSTATE CANCERhttps://orcid.org/0000-0003-3285-5559ВоробьевВладимир АнатольевичVorobevVladimir A.

доктор мед. наук, профессор кафедры факультетской хирургии и урологии

Dr. Sci. (Med.), Professor of the Department of Faculty Surgery and Urology

terdenecer@gmail.comhttps://orcid.org/0000-0003-1990-1207ЩербатыхАндрей ВикторовичShcherbatykhAndrey V.

д.м.н., профессор, заведующий кафедрой факультетской хирургии и урологии; ректор

Dr. Sci. (Med.), Professor, Head of the Department of Faculty Surgery and Urology; rector

irkutskii@mail.ruhttps://orcid.org/0000-0001-9278-9739ЛелявинКирилл БорисовичLelyavinKirill B.

Dr. Sci. (Med.), Associate Professor of the Department of Emergency Medical Care and Disaster Medicine

lelyavinK@rambler.ruhttps://orcid.org/0000-0003-1525-3425ТухиевАртур РуслановичTukhievArtur R.

аспирант кафедры факультетской хирургии и урологии

atukhiev@bk.ruСу-ЯнзКирилл МаксимовичSu-YanzKirill M.

студент 4 курса лечебного факультета

4th-year student of the Faculty of General Medicine

KirillSu15@yandex.ruhttps://orcid.org/0009-0003-0616-3257СыроваАсия ИсмаровнаSyrovaAsiya I.

студентка 4 курса лечебного факультета

4th-year student of the Faculty of General Medicine

syrovasiia@mail.ruhttps://orcid.org/0009-0001-9400-1738СыроваАмина ИсмаровнаSyrovaAmina I.

студентка 4 курса лечебного факультета

4th-year student of the Faculty of General Medicine

syrovamina2003@gmail.comИркутский государственный медицинский университет, ИркутскРоссияIrkutsk State Medical UniversityRussian FederationРоссийская медицинская академия непрерывного профессионального образования, ИркутскРоссияIrkutsk State Medical Academy of Postgraduate Education - branch of the Russian Medical Academy of Postgraduate EducationRussian Federation202510062025422231Copyright © Воробьев В.А., Щербатых А.В., Лелявин К.Б., Тухиев А.Р., Су-Янз К.М., Сырова А.И., Сырова А.И., 20252025Воробьев В.А., Щербатых А.В., Лелявин К.Б., Тухиев А.Р., Су-Янз К.М., Сырова А.И., Сырова А.И.Vorobev V.A., Shcherbatykh A.V., Lelyavin K.B., Tukhiev A.R., Su-Yanz K.M., Syrova A.I., Syrova A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/290Актуальность

Актуальность. Метастазы в органы зрения при раке предстательной железы встречаются крайне редко – менее 1 % всех опухолей орбиты, но имеют важное клиническое значение. Они сопровождаются болевым синдромом, нарушением зрения и, как правило, свидетельствуют о системном прогрессировании болезни.

Цель

Цель. Провести анализ современной литературы по вопросам клинической картины, диагностики, лечения и прогноза при офтальмологических метастазах рака предстательной железы.

Результаты

Результаты. Основные симптомы включают экзофтальм, снижение остроты зрения, диплопию и боль в орбите. Наиболее частыми локализациями являются орбитальные ткани и хориоидея. Диагностика требует высокой онконастороженности и включает магнитно-резонансную томографию орбит, позитронно-эмиссионную томографию/компьютерную томографию с PSMA, офтальмоскопию и биопсию. Повышение уровня простат-специфического антигена в сочетании с типичной офтальмологической симптоматикой служит ключевым диагностическим признаком. Лечение носит паллиативный характер: применяются андроген-депривационная терапия, химиотерапия и локальная лучевая терапия. В ряде случаев возможна частичная или полная регрессия метастазов, особенно при своевременно начатом лечении. Однако медиана выживаемости после выявления глазных метастазов обычно не превышает 7–24 месяцев.

Заключение

Заключение. Метастатическое поражение глаз при раке предстательной железы – маркер тяжёлого течения заболевания. Ранняя диагностика и мультидисциплинарный подход к лечению позволяют снизить выраженность симптомов и повысить качество жизни. Необходимо накопление клинических данных и поиск новых терапевтических подходов для оптимизации ведения пациентов с этим редким осложнением.

Background

Background. Ocular metastases from prostate cancer are extremely rare, accounting for less than 1 % of all orbital tumors. Despite their rarity, these lesions are clinically significant due to the risk of vision loss and pain, and they often indicate advanced systemic disease.

Objective

Objective. To review the current literature on the clinical features, diagnostic methods, treatment strategies, and prognosis of ocular metastases from prostate cancer.

Results

Results. Common manifestations include proptosis, visual acuity decline, diplopia, and orbital pain. Metastases typically involve the orbit or choroid. Diagnosis requires a high degree of clinical suspicion and includes orbital magnetic resonance imaging, PSMA positron emission tomography/computed tomography, ophthalmoscopy, and histopathological confirmation via biopsy. Elevated prostate-specific antigen levels with ocular symptoms strongly suggest metastatic prostate cancer. Treatment is mainly palliative and involves systemic androgen deprivation therapy, chemotherapy, and local radiotherapy. In some cases, regression of ocular lesions and symptom relief can be achieved, particularly if therapy is initiated early. Nevertheless, the median survival after diagnosis of ocular metastases is generally limited to 7–24 months.

Conclusion

Conclusion. Ocular involvement in prostate cancer represents a rare but serious metastatic manifestation. Early detection and a multidisciplinary therapeutic approach are essential to reduce symptom burden and improve quality of life. Further research and accumulation of clinical data are necessary to develop optimal management strategies for this uncommon complication.

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The authors declare that there are no conflicts of interest present.