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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

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ocular oncology

OCULAR ONCOLOGY

MICHAEL E GIBLIN

FRANZCO

slide2
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
Squamous cell carcinoma
  • Extensive
  • Ill defined edges
  • Vascularised
  • Corneal involvement
conjunctival melanoma
Conjunctival melanoma
  • Primary aquired conjunctival melanosis (PAM)
  • Preexisting conjunctival naevus
  • De novo
slide5
PAM
  • Primary acquired conjunctival melanosis
  • Biopsy if:
  • Growth
  • Nodule formation
  • Vascularity
rx conjunctival scc melanoma
Rx Conjunctival SCC / Melanoma
  • Excision / cryotherapy to cut conjunctival margin
  • Topical Mitomycin C
  • Episcleral plaque radiotherapy if recurrence
slide13

Choroidal naevus

Drusen

Fibrous metaplasia of RPE

uveal melanoma treatment
Uveal melanoma treatment
  • Observation
  • Tumours < 2mm thick
slide15

Symptoms

  • Thickness > 2mm
  • Orange pigment (lipofuscin)
  • Growth
  • Subretinal fluid
  • Peripapillary location
uveal melanoma treatment1
Uveal melanoma treatment
  • Observation
  • Transpupillary laser thermotherapy (TTT)
  • Thickness < 3.5mm
  • Posterior pole
uveal melanoma treatment2
Uveal melanoma treatment
  • Observation
  • TTT
  • Local resection

Base < 10mm

  • Anterior to
  • equator
uveal melanoma treatment3
Uveal melanoma treatment
  • Observation
  • TTT
  • Localresection
  • Radioactive plaque therapy
  • Base <15mm

Thickness < 8mm

slide20

Iodine 125

Ruthenium 106

uveal melanoma treatment4
Uveal melanoma treatment
  • Observation
  • TTT
  • Localresection
  • Radioactiveplaquetherapy
  • Proton beam/helium ion irradiation
  • Gamma knife therapy
uveal melanoma treatment5
Uveal melanoma treatment
  • Observation
  • TTT
  • Localresection
  • Radioactiveplaquetherapy
  • Protonbeam/helium ion irradiation
  • Gamma knife therapy
  • Enucleation
  • Base > 15mm
metastatic tumours
Metastatic tumours
  • Breast / lung carcinoma
  • Amelanotic
  • Multifocal
  • Choroidal
  • Treat only if sight affected
slide26

Amelanotic

Multifocal

Choroidal

Posterior to equator

slide28

M

AG

ICMI

KETHE

MEDICI

NEMAN