Presented BYPresented BY

General viewGeneral view• Most common Most common

intraocular tumour in intraocular tumour in adultadult

• Presentation:-Presentation:- decrease VAdecrease VA VF defect VF defect

photopsia photopsia asymptomatic asymptomatic

• Signs:Signs: elevated sub elevated sub retinal oval mass, retinal oval mass, dark color, lipofuscin dark color, lipofuscin orange color, orange color, exudative RD ……. exudative RD ……. others others

InvestigationsInvestigations• USUS

• FFAFFA

• ICG >> better ICG >> better than FFAthan FFA

• CT >> extrocular CT >> extrocular extensionextension

• MRIMRI

• DopplarDopplar

• Screen for mets.Screen for mets.

TreatmentTreatment

• Depend on the size: Depend on the size: largelarge > 8mm thick > 8mm thick

> 16mm diameter> 16mm diameter

mediummedium 3.1-8mm thick 3.1-8mm thick

5-16mm diameter5-16mm diameter

smallsmall 1-3 mm thick 1-3 mm thick

>5mm diameter>5mm diameter

• Location, extent, activity, state of the other Location, extent, activity, state of the other eye & general healtheye & general health

General Roles:( COMS )General Roles:( COMS )

• Large size: enculeationLarge size: enculeation

• Medium size: plaque radiotherapy Medium size: plaque radiotherapy (iodine-125 brachytherapy)(iodine-125 brachytherapy)

• Small size: Observation ( controversy !!)Small size: Observation ( controversy !!)

>>Others mod of Rx e.g. charged >>Others mod of Rx e.g. charged particle irradiation, TTT, Laser particle irradiation, TTT, Laser photocoagulation, local resectionphotocoagulation, local resection

Prognosis:Prognosis:

• Histological features: spindel cell 45%Histological features: spindel cell 45%

epithelioid cell 5%epithelioid cell 5%

mixed cell 45%mixed cell 45%

necrotic 5%necrotic 5%

• Size: small 16%, med 32%, large 53%Size: small 16%, med 32%, large 53%

• Extrascleral extensionExtrascleral extension

• LocationLocation

• AgeAge