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Intraocular tumours

Intraocular tumours. Dr. Mohammad Shehadeh Dalia Nader I rshaid. Choroidal naevus. Choroidal naevi are present in about 5 % of the general population but are less common in fair-skinned individuals.

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Intraocular tumours

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  1. Intraocular tumours Dr. Mohammad Shehadeh Dalia Nader Irshaid

  2. Choroidalnaevus • Choroidalnaevi are present in about 5 % of the general population but are less common in fair-skinned individuals. • Although they are probably present at birth , growth occurs mainly during the pre-pubertal years and is extremely rare thereafter.

  3. Signs • 1. typical naevus: • Asymptomayic • Oval or circular • Slate-blue or green-grey lesion • Not sharp borders which maybe associated with surface drusen • Dimensions are less than 5 mm in diameter and 1 mm or less in thickness

  4. typical choroidalnaevus

  5. Typical choroidalnaevuswith drusen

  6. 2. A suspicious naevus • Has one ore more of the following characteristics: • Presence of symptoms ,such as metamorphopsia and photopsia. • Dimensions >5 mm in diameter and >1 mm in thickness. • Clumps of surface orange pigment (lipofuscin). • Absence of surface drusen on a thick lesion. • Location of the posterior margin of the lesion within 3 mm of the optic disk. • Retinal detachment either over the surface of the lesion or inferiorly.

  7. The greater the number of these features , the higher the chance that the lesion is a melanoma.

  8. investigations • FA : most choroidalnaevi are avascular and pigmented, giving rise to hypoflurescence • If the naevus is associated with surface drusen this will results in areas of hyperfluorescence. • FA is not helpful in distinguishing a small melanoma from a naevus.

  9. management • 1. typical naevi : don’t need follow up because the risk of malignant transformation is extremely low. • 2. suspicious naevi : should be elevated initially every 3-6 months and then 9-12 months with fundus photo-graphy and ultrasonography to detect the possibility of growth.

  10. Metastatic tumours • The choroid is by far the most common site for uveal metastases , accounting for about 90%. Followed by the iris and ciliary body. Metastastictumours to the choroid are more common than primary malignancies but their presence is usually undetected by the patient’s general illness • The most frequent primary site is the breast in women and the bronchus in both sexes.

  11. Clinical features • presentation: • is usually with visual impairment although metastases ma be asymptomatic if located away from the macula.

  12. Signs • A fast-growing, creamy-white, placoid or oval lesion most frequently located at the posterior pole. • The tumer seldom becomes signficantly elevated because it infiltrates laterally. • Occasionally the deposits assume a globular shape and may mimic an amelanotic melanoma. • The deposits may be multiple and both eyes are involved in 10-30% of cases. • Secondary exudative retinal detachment is frequently and may occur in eyes with relatively small deposits.

  13. treatment • Observation • Radiotheraby • Transpupillary thermotherapy • Systemic therapy • encleation

  14. Thank you 

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