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Published byCathleen Russell Modified over 9 years ago
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IMPORTANT OPHTHALMIC TUMOURS MICHAEL E GIBLIN FRANZCO ASIA PACIFIC SOCIETY OF OCULAR ONCOLOGY AND PATHOLOGY
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Uveal melanoma
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Iris melanoma Large Diffuse Rapid growth Hyphaema Refractory glaucoma Subjacent ciliary body involvement
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Symptoms Thickness > 2mm Orange pigment (lipofuscin) Growth Subretinal fluid Peripapillary location Choroidal naevus versus melanoma
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MM treatment options Observation Transpupillary laser thermotherapy (TTT) Posterior pole Thickness < 3.5mm
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Melanoma treatment options Observation TTT Local resection Base < 10mm Anterior to equator
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MM treatment options Observation TTT Local resection Radioactive plaque therapy Base <15(18)mm Thickness < 8mm
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Ruthenium 106 Iodine 125
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MM treatment options Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Stereotactic R/T; LINAC/gamma knife
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MM treatment options Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Sterertactic radiotherapy Enucleation Base > 18mm
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BAP1 BAP1 = BRCA Associated Protein 1 Recessive cancer suppression gene Located on 3p21.1 Associated with monosomy 3 Inactivating mutation leads to liver metastasis
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Circumscribed choroidal haemangioma
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High internal reflectivity
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Metastatic tumours May be multifocal Characteristically posterior to equator Usually amelanotic Leopard-skin RPE spotting Sub-retinal fluid if active Treat if sight affected Lung ca. Choroidal metastasis may precede detection of primary
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Retinoblastoma
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Aim for earlier detection Chemotherapy mainstay of treatment for hereditary retinoblastoma Incresing role for intraarterial chemotherapy
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