Metastatic lesions of the eye organs in prostate cancer. A systematic review and meta-analysis according to the PRISMA protocol 2020

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Abstract
Aim. To perform systematic review of the literature published in 2000–2024 and meta-analysis of the data according to the PRISMA protocol 2020. Materials and methods. Data on clinical cases of 60 patients with prostate cancer metastases to ocular structures (orbit or eye) reported from 2000 to 2024 were analyzed. The resulting cohort is the largest on this topic in the last two decades. Results. Prostate cancer metastases most frequently involved the orbit (including the optic nerve) and choroid; involvement of the iris or ciliary body was rare. In 17 % of patients, ocular symptoms were the first manifestation leading to a prostate cancer diagnosis. The optimal treatment approach was a combination of systemic prostate cancer therapy (androgen deprivation ± chemotherapy) with local ocular radiotherapy. Hormone therapy played a key role in prolonging survival and improving quality of life, whereas orbital radiation was effective for palliating symptoms and partially restoring vision. The median survival after detection of ocular metastases was approximately 6–12 months. Conclusion. Ocular metastases of prostate cancer are an extremely rare but clinically significant condition. Timely diagnosis and combined systemic and local treatment may improve the prognosis and quality of life of such patients despite an overall poor outcome. Limitations. The retrospective and heterogeneous nature of available data, small sample size (60 cases), and potential publication bias limit the generalizability of the results.

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