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- small, rare, 40, slow growth, excellent prog
- 2ndy glauc
- vessels: ddx epi/scleritis
- sentinel vessels, extraoc expansion, erosion of iris root, lens subluxation, cataract, RD
- grey, indistinct margins, flatish, asx
- sus: elevation, lipofuscin
Choroidal melanoma genetics?
- most common primary intraoc tumour in adults
- large tumour size, old
- GNAQ mutation: early pathogenesis (-)metastasis
- inactivation BAP1 (tumour/metasis suppressor)- monosomy 3: metastatic spread
- gain 6p: better prognosis
- gain 8p: worse prognosis
choroidal melanoma signs?
- brown, elevated subretinal mass
- vessels on surface
- choroidal folds- compression
Choroidal melanoma metastasis?
- bad prognosis
- 50% metastases within 15 years tx primary
DDX choroidal melanoma?
- choroidal naevus
- metastatic tumour
- choroidal haemangioma
- choroidal detachment/granuloma
- subret haem
Risk factors choroidal melanoma?
- orange pigment
Optic nerve melanocytoma?
- asx, no growth~RAPD
- slow growth compress ON-VA loss, CRVO
ON melanocytoma vs melanoma?
- melanoma: varied presenation, patchy pig, distorted bv
- surface deposits
- ret/disc edema, haem, RD
- dome, placoid red-orange mass, post pole
- blanch with pressure
- cystoid retinal degen
choroidal osseous choristoma
- rare, benign, slow bony tumour
- 20-30 f
- mottled appeareance, RPE defen over lesion
- yellow, scalloped
- 2ndy cancers later life
Presentation of Rb?
- ant invasion,
- orbital inflammation
- 2ndy glaucoma
- coloboma, cataract, coats
- morning glory anomaly
- endo: grown into vit, friable white mass, cottage cheese,
- exo: proliferations in SRS- serous detachment
- small: laser photo, cryo
- medium: chemo
- Large: chemo, enucleation
- PVRL: CNS lymphoma refer
- micrscopic metatstatic intraocular lesions
- fast growing, creamy placoid lesion, post pole
- multiple deposits
- precede cancer- lung, melanoma, ovarian, prostate
- immune response to cancer
- CAR. MAR
- acute vision loss, nyctalopia, photophobia, CV, flickering
- PRECEDE CANCER-CAR
- MAR- POST diagnosis
ERG: b wave abnormal- ON bipolar cells