ocular oncology michael e giblin franzco. ossn ocular surface squamous neoplasia encompasses...

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  • OCULAR ONCOLOGYMICHAEL E GIBLINFRANZCO

  • OSSNOcular surface squamous neoplasiaEncompasses conjunctival/corneal intraepithelial neoplasia (CIN)

    Squamous conjunctival dysplasiaCarcinoma in situInvasive squamous cell carcinoma (SCC)

  • Squamous cell carcinomaExtensiveIll defined edgesVascularisedCorneal involvement

  • Conjunctival melanomaPrimary aquired conjunctival melanosis (PAM)Preexisting conjunctival naevusDe novo

  • PAMPrimary acquired conjunctival melanosisBiopsy if:GrowthNodule formationVascularity

  • De novo conjunctival melanoma

  • Rx Conjunctival SCC / MelanomaExcision / cryotherapy to cut conjunctival marginTopical Mitomycin CEpiscleral plaque radiotherapy if recurrence

  • Iris melanoma

  • Congenital hypertrophy of the retinal pigment epithelium (CHRPE)

  • Choroidal neovascularisation: high myopia (Fuchs spot)

  • Choroidal haemangioma

  • Melanocytic tumours of the posterior uveaNaevusMelanoma

  • DrusenFibrous metaplasia of RPEChoroidal naevus

  • Uveal melanoma treatmentObservationTumours < 2mm thick

  • SymptomsThickness > 2mmOrange pigment (lipofuscin)GrowthSubretinal fluidPeripapillary location

  • Uveal melanoma treatmentObservationTranspupillary laser thermotherapy (TTT)

    Posterior poleThickness < 3.5mm

  • Uveal melanoma treatmentObservationTTTLocal resection

    Anterior to equatorBase < 10mm

  • Uveal melanoma treatmentObservationTTTLocal resectionRadioactive plaque therapyThickness < 8mmBase
  • Ruthenium 106Iodine 125

  • Uveal melanoma treatmentObservationTTTLocal resectionRadioactive plaque therapyProton beam/helium ion irradiationGamma knife therapy

  • Uveal melanoma treatmentObservationTTTLocal resectionRadioactive plaque therapyProton beam/helium ion irradiationGamma knife therapyEnucleationBase > 15mm

  • Metastatic tumoursBreast / lung carcinoma

    AmelanoticMultifocalChoroidal

    Treat only if sight affected

  • AmelanoticMultifocalChoroidalPosterior to equator

  • MAGICMIKETHEMEDICINEMAN

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