CHOROIDAL MELANOMA
SIVATEJA CHALLA
DEFINITION
EPIDEMIOLOGY
ETIOLOGY
MOLECULAR GENETICS
Molecular genetics
HPE and IHC
PATHOLOGY GROSS
PATHO MICRO
CLINICAL FEATURES
Bruchs intact Bruchs membrane ruptured
Highly pimented melanoma
Orange pigment on surface
Diffuse melanoma
Amelanotic melanoma
Collar stud
With exudative RD
Orange pigmentation
extensions
METASTASIS
INVESTIGATIONS
USG
FFA
CT
MRI
DIFFERENTIALS
Nevus to melanoma“To Find Small Ocular Melanoma Using Helpful Hints Daily”(TFSOM-UHHD)
T thickness greater than 2 mm,F fluid subretinallyS symptomsO Orange pigment present,M margin with in 3 mm of the optic discUH USG hollowness (versus solid/flat)H haloD drusen absent
CHRPE
MELANOCYTOMA
CHOROIDAL HGE
HEMANGIOMA
53 SEC 10 MINS
20 MINS
VS HEMANGIOMA
COLLOBORATIVE OCULAR MELANOMA STUDY (COMS)
COMS
TREATMENT
TREATMENT
• Observation• Enucleation• Brachytherapy• Charged particle
radiation• External beam radiation
• Photoablation/transpupillary thermotherapy
• Cryotherapy• Trans scleral diathermy• Surgical excision of
tumour• Chemotherapy• Immunotherapy• exenteration
Nevus to melanoma“To Find Small Ocular Melanoma Using Helpful Hints Daily”(TFSOM-UHHD)
T thickness greater than 2 mm,F fluid subretinallyS symptomsO Orange pigment present,M margin with in 3 mm of the optic discUH USG hollowness (versus solid/flat)H haloD drusen absent
ENUCLEATION
Later can be palnned for implants
BRACHYTHERAPY
Charged particle radiation
Stereotactic radiotheraphy
THERMOTHERAPY
Trans scleral choroidectomy
Transretinal choroidectiomy
PROGNOSIS
REFERENCES
1.Ocular oncology 1/e, Arun D.singh2.Retina 5/e, stephen J. Ryan, MD, Andrew P. Schachat, MD3.OPHTHALMOLOGY 4/e, Yanoff and Duker4.Clinical ophthalmology 7/e,kanski5.AAO,section 4 ,ophthalmic pathology and intraocular tumours
THANK YOU
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