Presentation on theme: " IMPORTANT OPHTHALMIC TUMOURS"— Presentation transcript
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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
LargeDiffuseRapid growthHyphaemaRefractory glaucomaSubjacent ciliary body involvement
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Symptoms
Thickness > 2mm
Orange pigment (lipofuscin)GrowthSubretinal fluidPeripapillary location
Choroidal
naevus versus melanoma
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MM treatment options
ObservationTranspupillary laser thermotherapy (TTT)
Posterior pole
Thickness < 3.5mm
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Melanoma treatment options
ObservationTTTLocal resection
Base < 10mmAnterior to equator
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MM treatment options
ObservationTTTLocal resectionRadioactive 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
ObservationTTTLocal resectionRadioactive plaque therapyProton beam/helium ion irradiationSterertactic radiotherapyEnucleation
Base > 18mm
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BAP1
BAP1 = BRCA Associated Protein 1
Recessive cancer suppression gene
Located on 3p21.1
Associated with monosomy 3
In
activating 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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Retinoblastoma
Aim for earlier detection
Chemotherapy mainstay of treatment for hereditary retinoblastoma
Incresing
role for
intraarterial
chemotherapy
