choroidal melanoma

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

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