a 52-year - old woman sought treatment for decreased visual acuity of 1 month in the right eye . the patient was previously treated with radial mastectomy and chemotherapy 5 years ago for an invasive ductal carcinoma of the right breast . lung , liver , bone and brain metastases were found 1 year previously . on initial examination , visual acuity with correction was 0.63/0.8 ( od / os ) and intraocular pressure ( iop ) was 15/16 mmhg . right fundoscopy revealed an elevated mass - like lesion at temporal to the macule with serous retinal detachment . no choroidal lesions were observed in the left fundus.a right fluorescein angiogram revealed hypofluorescence during the prearterial and arteriovenous phase and hyperfluorescence during the venous phase . the venous phase showed nearly complete masking of background choroidal fluorescence at the elevated lesion due to leakage and neovascularization ( fig . treatment was started with diode lasers while the patient was undergoing chemotherapy in hematology ( gemzar - navelvin 4th , taxotere - cis 3rd ) . the typical settings were as follows : intensity , 300 - 400 milliwatts ; duration , 0.2 seconds ; size , 200 - 500 microns ; 250 - 300 shot per serial . the patient underwent treatment with a diode laser once a week for a total of 4 weeks . after 50 days , right funduscopy revealed mass regression in size and height and resolved retinal detachment . right fluorescein angiogram revealed a flat devascularized choroid , the venous phase showed some leakages from the old lesion that affected the fovea ( fig . the various methods for treatment of choroidal metastasis areas follows : observation , radiotherapy , laser photocoagulation , transpupillary thermotherapy , chemotherapy , and enucleation.3 radiotherapy is the preferred modality for local treatment of an ocular tumor . although shown to be very effective , 3 to 4 weeks of daily radiation treatment is necessary , which many patients with metastasis find daunting , considering the serious condition of their health.4 radiotherapy presents a risk for local complications such as cataracts , dry eye syndrome , and radiation retinopathy.3,5 according to halpern and colleagues,6 chemotherapy alone is effective in approximately one third of the cases . however , systemic therapy has side effects such as gastrointestinal manifestation , fatigue , generalized weakness , neutropenia , or cardiotoxic effects.7 laser photocoagulation yields a rapid response , is easy to perform on an outpatient basis , and is an effective therapy . levinger and colleagues,5 treated 10 eyes of 7 patients with krypton red or argon green laser applications for small choroidal breast carcinoma metastasis with serous detachment of the retina . in all eyes , the tumor decreased , the subretinal serous detachment was absorbed , the retina flattened , and the visual acuity improved without complications . the method by which the laser is effective in eradicating choroidal metastases is not clear . according to levinger and colleagues,5 the effectiveness of the laser treatment was not a result of occlusion of the retinal or choroidal blood circulation . a possible explanation for the mode of laser action is the destruction of the vasculature of the tumor . in other words , the laser closes all the blood vessels of the tumor , causing the tumor cells to die . glaser and colleagues8,9 suggested that laser treatment may effect the retina and choroid through the release of extracellular modulating factors by laser - induced chorioretinal scars including neovascularization inhibiting factors . if this theory is correct , the laser may induce destruction of the metastatic tumor by inhibition of the tumor angiogenesis , and formation of ischemia.5 in this study , diode laser photocoagulation was selected because the patient 's physical condition was poor and the laser procedure was short . consequently , the mass regressed , subretinal serous detachment was absorbed , and the visual acuity improved . laser photocoagulation does not appear to cause complications for the patient and may be an effective treatment for patients with choroidal metastasis of breast carcinoma .
to report a single case of improvement on choroidal metastasis of breast cancer after laser photocoagulation . a 52-year - old female patient who complained of visual disturbance of the right eye with multiple states of metastasis of breast carcinoma . on initial examination , 
 the right best - corrected visual acuity was 0.63 . 
 right fundoscopy revealed an elevated mass - like lesion temporal to the macule with serous retinal detachment . 
 the mass had a 3.5-disc diameter . a right fluorescein angiogram revealed hypofluorescence during the prearterial and arteriovenous phase and hyperfluorescence during the venous phase . 
 the venous phase showed almost total masking of background choroidal fluorescence at the elevated lesion because of leakage and neovascularization . 
 the patient was treated 4 times by diode laser photocoagulation in addition to chemotherapy . 
 fifty days after the diode laser treatments , the funduscopy examination and fluorescein angiogram revealed that the serous retinal detachment had been absorbed , the choroid had become flat , the lesion had been reduced in size and hyperfluorescence . 
 the right best - corrected visual acuity was improved to 0.8 . 
 laser photocoagulation appears not to cause any problems for the patient and may be an efficient treatment for patients with choroidal breast carcinoma .