Woman with Painless Visual Reduction

A 55-year-old woman presented to the emergency department with a 1-week history of painless visual reduction in the left eye. The patient had received a diagnosis of left invasive breast carcinoma, with distant organ metastases to the bone, lung, liver, and brain. She denied any history of ocular surgery or trauma. At presentation, her visual acuity was 20/200. Her anterior segment was unremarkable. Fundus photography of the left eye showed an ill-defined, yellow-white choroidal lesion approaching the macula, combined with macular edema and superficial retinal hemorrhage (Fig 1).