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General view Most common intraocular tumour in adult Most common intraocular tumour in adult Presentation:- Presentation:- decrease VA decrease VA VF defect photopsia asymptomatic VF defect photopsia asymptomatic Signs: elevated sub retinal oval mass, dark color, lipofuscin orange color, exudative RD ……. others Signs: elevated sub retinal oval mass, dark color, lipofuscin orange color, exudative RD ……. others

Investigations US US FFA FFA ICG >> better than FFA ICG >> better than FFA CT >> extrocular extension CT >> extrocular extension MRI MRI Dopplar Dopplar Screen for mets. Screen for mets.

Treatment Depend on the size: large > 8mm thick Depend on the size: large > 8mm thick > 16mm diameter > 16mm diameter medium 3.1-8mm thick medium 3.1-8mm thick 5-16mm diameter 5-16mm diameter small 1-3 mm thick small 1-3 mm thick >5mm diameter >5mm diameter Location, extent, activity, state of the other eye & general health Location, extent, activity, state of the other eye & general health

General Roles:( COMS ) Large size: enculeation Large size: enculeation Medium size: plaque radiotherapy (iodine-125 brachytherapy) Medium size: plaque radiotherapy (iodine-125 brachytherapy) Small size: Observation ( controversy !!) Small size: Observation ( controversy !!) >>Others mod of Rx e.g. charged particle irradiation, TTT, Laser photocoagulation, local resection

Prognosis: Histological features: spindel cell 45% Histological features: spindel cell 45% epithelioid cell 5% epithelioid cell 5% mixed cell 45% mixed cell 45% necrotic 5% necrotic 5% Size: small 16%, med 32%, large 53% Size: small 16%, med 32%, large 53% Extrascleral extension Extrascleral extension Location Location Age Age