UVEAL METASTASIS FROM PROSTATE CANCER

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

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. 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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