Bilateral Choroidal Metastases from Breast Carcinoma: A Case Report with Multimodal Imaging

Introduction: Choroidal metastases are the most common intraocular malignancies, with breast carcinoma being the leading primary tumor in women. Bilateral involvement associated with exudative retinal detachment is uncommon and potentially sight-threatening. Case Presentation: A 31-year-old black woman with a history of left breast carcinoma treated by mastectomy and adjuvant chemoradiotherapy presented with progressive visual loss and photopsia in both eyes. Fundus examination revealed bilateral exudative retinal detachment with macular involvement in the left eye. Multimodal imaging using fundus photography, B-scan ultrasonography and computed tomography demonstrated bilateral choroidal masses consistent with metastatic disease. Despite referral for systemic oncological management, the patient declined chemotherapy and was followed for 33 days, showing progression of the choroidal lesions. Conclusion: Choroidal metastases should be suspected in any patient with breast cancer presenting with visual symptoms. Multimodal ocular imaging is crucial for diagnosis.