**Author details**

Roy Schwartz and Zohar Habot-Wilner\*

\*Address all correspondence to: zoharhw@tlvmc.gov.il

Ophthalmology division, Tel-Aviv Medical Center, the Sackler Faculty of Medicine, Tel Aviv University, Israel

### **References**

*6.3.2. Tumor metastasis*

174 Advances in Eye Surgery

malignancy is identified. [21]

without a known primary tumor. [88]

considered unsolvable or untreatable.

Roy Schwartz and Zohar Habot-Wilner\*

\*Address all correspondence to: zoharhw@tlvmc.gov.il

**7. Summary**

**Author details**

Aviv University, Israel

Tumor metastasis is the most common cause of intraocular malignancy in adults. [78] While their typical appearance and preexisting history of cancer typically lead to diagnosis, uveal

A few cases were reported on the use of aqueous sampling for cytology which led to the diagnosis of metastases masquerading as anterior uveitis. [79-84] Of patients undergoing diagnostic vitrectomy for uveitis of unknown cause, detection of metastasis from cytology results was rare in the literature, [11, 85, 86] with only one case reported in each of these series. In case reports of patients with the rare occurrence of tumors metastatic to the retina and vitreous, these conditions present as intermediate uveitis, vitreous hemorrhage, or retinal vasculitis with vitreous cytology and retinal biopsy assisting in diagnosis if no primary

In a series of 159 cases by Shields et al, [87] transocular fine needle aspiration (FNA) biopsy led to an adequate sample collection in 88% of cases, with a sensitivity rate of 100% and specificity rate of 98%, leading to diagnosis of intraocular malignancies such as uveal mela‐ noma, uveal metastasis, retinoblastoma, lymphoma, and leukemia. In another series of 39 patients with uveal metastasis undergoing ocular biopsy of the tumor, 25 G vitrectomy had a yield of 100% for cytologic diagnosis. It indicated the site of origin in 24 out of 27 patients

Diagnostic procedures in ophthalmology have gone a long way from the early days of pars plana vitrectomy, when instrumentation and diagnostic methods were limited and the amount

As this chapter has shown, the approach to a patient with a cryptic diagnosis, a rapidly deteriorating disease, or treatment failure has changed in the last decades and ophthalmolo‐ gists now have in their arsenal a battery of tools to help in the diagnosis of cases that were once

Ophthalmology division, Tel-Aviv Medical Center, the Sackler Faculty of Medicine, Tel

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**Cataract & Refractive Surgery**
