Ocular metastasis from esophageal cancer: a systematic review and pooled analysis of individual-level case data.

In 30 seconds

This systematic review and pooled analysis of individual-level case data examined adult ocular metastasis from esophageal cancer, drawing on 41 published cases identified through searches of PubMed/Medline and Scopus. Blurred vision was the most common presenting symptom (46.3%), and the choroid was the most frequently involved site (43.8%). Ocular metastasis was synchronous with the primary cancer in 63.4% of cases, while 80.5% had additional systemic metastases. Median overall survival was 6 months. External beam radiotherapy was the most common local treatment and was associated with visual improvement in approximately two-thirds of treated patients.

Key findings

• Blurred vision was reported in 46.3% of cases; impaired visual acuity was documented in 85.3% of cases with reported data.
• The choroid was involved in 43.8% of cases, followed by the iris in 31.3%.
• Ocular metastasis was synchronous in 63.4% of cases and the presenting manifestation in 29.3%; 80.5% had additional systemic metastases.
• External beam radiotherapy was used most often (68.3%), with visual improvement in approximately two-thirds of treated patients; median overall survival was 6 months.

Why it matters

These pooled case data describe a presentation that may involve substantial visual impairment and commonly occurs alongside widespread disease. Recognising ocular symptoms in the context of esophageal cancer can help clinicians identify metastatic involvement and assess visual function. The short median survival also underscores the importance of considering ocular outcomes and quality of life within the broader context of advanced systemic disease.

What to keep in mind

The review is based on 41 published cases, largely reflecting isolated case reports; the evidence is descriptive and may be affected by publication and reporting bias.