OCULAR ONCOLOGY MICHAEL E GIBLIN FRANZCO. OSSN Ocular surface squamous neoplasia Encompasses conjunctival/corneal intraepithelial neoplasia (CIN) Squamous.

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Presentation transcript:

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 Ill defined edges Vascularised Corneal involvement

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

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

De novo conjunctival melanoma

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

Iris melanoma

Congenital hypertrophy of the retinal pigment epithelium (CHRPE)

Choroidal neovascularisation: high myopia (Fuch’s spot)

Choroidal haemangioma

Melanocytic tumours of the posterior uvea Naevus Melanoma

Drusen Fibrous metaplasia of RPE Choroidal naevus

Uveal melanoma treatment Observation Tumours < 2mm thick

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

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

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

Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Thickness < 8mm Base <15mm

Ruthenium 106 Iodine 125

Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Gamma knife therapy

Uveal melanoma treatment Observation TTT Local resection Radioactive plaque therapy Proton beam/helium ion irradiation Gamma knife therapy Enucleation Base > 15mm

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

Amelanotic Multifocal Choroidal Posterior to equator

M AG ICMI KETHE MEDICI NEMAN