MICHAEL E GIBLIN FRANZCO ASIA PACIFIC SOCIETY OF OCULAR ONCOLOGY AND PATHOLOGY Uveal melanoma Iris melanoma Large Diffuse Rapid growth Hyphaema Refractory glaucoma Subjacent ciliary body involvement ID: 776701
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IMPORTANT OPHTHALMIC TUMOURS
MICHAEL E GIBLIN FRANZCO
ASIA PACIFIC SOCIETY OF OCULAR ONCOLOGY AND PATHOLOGY
Slide2Uveal melanoma
Slide3Iris melanoma
LargeDiffuseRapid growthHyphaemaRefractory glaucomaSubjacent ciliary body involvement
Slide4Symptoms
Thickness > 2mm
Orange pigment (lipofuscin)GrowthSubretinal fluidPeripapillary location
Choroidal
naevus versus melanoma
Slide5MM treatment options
ObservationTranspupillary laser thermotherapy (TTT)
Posterior pole
Thickness < 3.5mm
Slide6Slide7Melanoma treatment options
ObservationTTTLocal resection
Base < 10mmAnterior to equator
Slide8MM treatment options
ObservationTTTLocal resectionRadioactive plaque therapy
Base <15(18)mm
Thickness < 8mm
Slide9Ruthenium 106
Iodine 125
Slide10MM treatment options
Observation
TTT
Local resection
Radioactive plaque therapy
Proton beam/helium ion irradiation
Stereotactic R/T; LINAC/gamma knife
Slide11MM treatment options
ObservationTTTLocal resectionRadioactive plaque therapyProton beam/helium ion irradiationSterertactic radiotherapyEnucleation
Base > 18mm
Slide12BAP1
BAP1 = BRCA Associated Protein 1
Recessive cancer suppression gene
Located on 3p21.1
Associated with monosomy 3
In
activating mutation leads to liver metastasis
Slide13Circumscribed
choroidal
haemangioma
Slide14High internal reflectivity
Slide15Metastatic 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
Slide16Slide17Retinoblastoma
Slide18Retinoblastoma
Aim for earlier detection
Chemotherapy mainstay of treatment for hereditary retinoblastoma
Incresing
role for
intraarterial
chemotherapy