choroidam melanoma,intra ocular tumour

1. CHOROIDAL MELANOMA
SIVATEJA CHALLA

2. DEFINITION

3. EPIDEMIOLOGY

4. ETIOLOGY

5. MOLECULAR GENETICS

6. Molecular genetics

8. HPE and IHC

9. PATHOLOGY GROSS

10. PATHO MICRO

12. CLINICAL FEATURES

13. Bruchs intact Bruchs membrane ruptured

14. Highly pimented
melanoma
Orange pigment
on surface
Diffuse melanoma
Amelanotic
melanoma
Collar stud
With exudative
RD

15. Orange pigmentation

16. extensions

18. METASTASIS

19. INVESTIGATIONS

20. USG

21. FFA

22. CT

23. MRI

24. DIFFERENTIALS

25. Nevus to melanoma
“To Find Small Ocular Melanoma
Using Helpful Hints Daily”(TFSOM-
UHHD)
T  thickness greater than 2 mm,
F  fluid subretinally
S  symptoms
O Orange pigment present,
M  margin with in 3 mm of the optic disc
UH USG hollowness (versus solid/flat)
H halo
D drusen absent

26. CHRPE

27. MELANOCYTOMA

28. CHOROIDAL HGE

29. HEMANGIOMA

30. 53 SEC 10 MINS
20 MINS

31. VS HEMANGIOMA

32. COLLOBORATIVE OCULAR MELANOMA
STUDY (COMS)

33. COMS

35. TREATMENT

36. TREATMENT
• Observation
• Enucleation
• Brachytherapy
• Charged particle
radiation
• External beam radiation
• Photoablation/transpup
illary thermotherapy
• Cryotherapy
• Trans scleral diathermy
• Surgical excision of
tumour
• Chemotherapy
• Immunotherapy
• exenteration

37. Nevus to melanoma
“To Find Small Ocular Melanoma
Using Helpful Hints Daily”(TFSOM-
UHHD)
T  thickness greater than 2 mm,
F  fluid subretinally
S  symptoms
O Orange pigment present,
M  margin with in 3 mm of the optic disc
UH USG hollowness (versus solid/flat)
H halo
D drusen absent

38. ENUCLEATION

39. Later can be palnned for implants

40. BRACHYTHERAPY

42. Charged particle radiation

43. Stereotactic radiotheraphy

44. THERMOTHERAPY

45. Trans scleral choroidectomy

46. Transretinal choroidectiomy

47. PROGNOSIS

48. REFERENCES
1.Ocular oncology 1/e, Arun D.singh
2.Retina 5/e, stephen J. Ryan, MD, Andrew P.
Schachat, MD
3.OPHTHALMOLOGY 4/e, Yanoff and Duker
4.Clinical ophthalmology 7/e,kanski
5.AAO,section 4 ,ophthalmic pathology and
intraocular tumours

49. THANK YOU