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Published byEaster Norton Modified over 9 years ago
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OCULAR ONCOLOGY MICHAEL E GIBLIN FRANZCO
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OSSN Ocular surface squamous neoplasia Encompasses conjunctival/corneal intraepithelial neoplasia (CIN) Squamous conjunctival dysplasia Carcinoma in situ Invasive squamous cell carcinoma (SCC)
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Squamous cell carcinoma Extensive Ill defined edges Vascularised Corneal involvement
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Conjunctival melanoma Primary aquired conjunctival melanosis (PAM) Preexisting conjunctival naevus De novo
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PAM Primary acquired conjunctival melanosis Biopsy if: Growth Nodule formation Vascularity
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De novo conjunctival melanoma
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Rx Conjunctival SCC / Melanoma Excision / cryotherapy to cut conjunctival margin Topical Mitomycin C Episcleral plaque radiotherapy if recurrence
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Iris melanoma
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Congenital hypertrophy of the retinal pigment epithelium (CHRPE)
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Choroidal neovascularisation: high myopia (Fuch’s spot)
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Choroidal haemangioma
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Melanocytic tumours of the posterior uvea Naevus Melanoma
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Drusen Fibrous metaplasia of RPE Choroidal naevus
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Uveal melanoma treatment Observation Tumours < 2mm thick
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Symptoms Thickness > 2mm Orange pigment (lipofuscin) Growth Subretinal fluid Peripapillary location
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Uveal melanoma treatment Observation Transpupillary laser thermotherapy (TTT) Posterior pole Thickness < 3.5mm
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Uveal melanoma treatment Observation TTT Local resection Anterior to equator Base < 10mm
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Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Thickness < 8mm Base <15mm
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Ruthenium 106 Iodine 125
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Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Gamma knife therapy
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Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Gamma knife therapy Enucleation Base > 15mm
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Metastatic tumours Breast / lung carcinoma Amelanotic Multifocal Choroidal Treat only if sight affected
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Amelanotic Multifocal Choroidal Posterior to equator
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M AG ICMI KETHE MEDICI NEMAN
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