Post on 15-Jan-2016
Presented BYPresented BY
General viewGeneral view• Most common Most common
intraocular tumour in intraocular tumour in adultadult
• Presentation:-Presentation:- decrease VAdecrease VA VF defect VF defect
photopsia photopsia asymptomatic asymptomatic
• Signs:Signs: elevated sub elevated sub retinal oval mass, retinal oval mass, dark color, lipofuscin dark color, lipofuscin orange color, orange color, exudative RD ……. exudative RD ……. others others
InvestigationsInvestigations• USUS
• FFAFFA
• ICG >> better ICG >> better than FFAthan FFA
• CT >> extrocular CT >> extrocular extensionextension
• MRIMRI
• DopplarDopplar
• Screen for mets.Screen for mets.
TreatmentTreatment
• Depend on the size: Depend on the size: largelarge > 8mm thick > 8mm thick
> 16mm diameter> 16mm diameter
mediummedium 3.1-8mm thick 3.1-8mm thick
5-16mm diameter5-16mm diameter
smallsmall 1-3 mm thick 1-3 mm thick
>5mm diameter>5mm diameter
• Location, extent, activity, state of the other Location, extent, activity, state of the other eye & general healtheye & general health
General Roles:( COMS )General Roles:( COMS )
• Large size: enculeationLarge size: enculeation
• Medium size: plaque radiotherapy Medium size: plaque radiotherapy (iodine-125 brachytherapy)(iodine-125 brachytherapy)
• Small size: Observation ( controversy !!)Small size: Observation ( controversy !!)
>>Others mod of Rx e.g. charged >>Others mod of Rx e.g. charged particle irradiation, TTT, Laser particle irradiation, TTT, Laser photocoagulation, local resectionphotocoagulation, local resection
Prognosis:Prognosis:
• Histological features: spindel cell 45%Histological features: spindel cell 45%
epithelioid cell 5%epithelioid cell 5%
mixed cell 45%mixed cell 45%
necrotic 5%necrotic 5%
• Size: small 16%, med 32%, large 53%Size: small 16%, med 32%, large 53%
• Extrascleral extensionExtrascleral extension
• LocationLocation
• AgeAge