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OCULAR ONCOLOGY

OCULAR ONCOLOGY. MICHAEL E GIBLIN FRANZCO. OSSN. Ocular surface squamous neoplasia Encompasses conjunctival/corneal intraepithelial neoplasia (CIN) Squamous conjunctival dysplasia Carcinoma in situ Invasive squamous cell carcinoma (SCC). Squamous cell carcinoma. Extensive

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OCULAR ONCOLOGY

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  1. OCULAR ONCOLOGY MICHAEL E GIBLIN FRANZCO

  2. OSSN • Ocular surface squamous neoplasia • Encompasses conjunctival/corneal intraepithelial neoplasia (CIN) • Squamous conjunctival dysplasia • Carcinoma in situ • Invasive squamous cell carcinoma (SCC)

  3. Squamous cell carcinoma • Extensive • Ill defined edges • Vascularised • Corneal involvement

  4. Conjunctival melanoma • Primary aquired conjunctival melanosis (PAM) • Preexisting conjunctival naevus • De novo

  5. PAM • Primary acquired conjunctival melanosis • Biopsy if: • Growth • Nodule formation • Vascularity

  6. De novo conjunctival melanoma

  7. Rx Conjunctival SCC / Melanoma • Excision / cryotherapy to cut conjunctival margin • Topical Mitomycin C • Episcleral plaque radiotherapy if recurrence

  8. Iris melanoma

  9. Congenital hypertrophy of the retinal pigment epithelium (CHRPE)

  10. Choroidal neovascularisation: high myopia (Fuch’s spot)

  11. Choroidal haemangioma

  12. Melanocytic tumours of the posterior uvea • Naevus • Melanoma

  13. Choroidal naevus Drusen Fibrous metaplasia of RPE

  14. Uveal melanoma treatment • Observation • Tumours < 2mm thick

  15. Symptoms • Thickness > 2mm • Orange pigment (lipofuscin) • Growth • Subretinal fluid • Peripapillary location

  16. Uveal melanoma treatment • Observation • Transpupillary laser thermotherapy (TTT) • Thickness < 3.5mm • Posterior pole

  17. Uveal melanoma treatment • Observation • TTT • Local resection Base < 10mm • Anterior to • equator

  18. Uveal melanoma treatment • Observation • TTT • Localresection • Radioactive plaque therapy • Base <15mm Thickness < 8mm

  19. Iodine 125 Ruthenium 106

  20. Uveal melanoma treatment • Observation • TTT • Localresection • Radioactiveplaquetherapy • Proton beam/helium ion irradiation • Gamma knife therapy

  21. Uveal melanoma treatment • Observation • TTT • Localresection • Radioactiveplaquetherapy • Protonbeam/helium ion irradiation • Gamma knife therapy • Enucleation • Base > 15mm

  22. Metastatic tumours • Breast / lung carcinoma • Amelanotic • Multifocal • Choroidal • Treat only if sight affected

  23. Amelanotic Multifocal Choroidal Posterior to equator

  24. M AG ICMI KETHE MEDICI NEMAN

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