Retinal metastases are rare and cause vitreous seeding, can be confused with retinitis. Usually present with uveal metastases and often with brain metastases. Vitreous metastases occur with metastatic melanoma and present with floaters. Painless nodule is most common symptom. Often mistaken for chalazion or primary skin tumor.
Lesions show high reflectivity in characteristic V-pattern.
Lower reflectivity in the center of the lesion due to higher cell density. Iris fluoroscein angiography and AC paracentesis, fine needle biopsy for anterior lesions. Vitrectomy or vitreous aspiration for posterior lesions with seeding. MRI useful for distinguishing melanoma from intraocular metastases but has limited usefulness with amelanotic lesions because melanin aids in demarcation of lesions. Overall period of survival is 6-12 months.