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Вуз:

Ростовский Государственный Медицинский Университет

Предмет:

Медицина общая

Файл:

Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001

.pdf

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28.03.2026

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Serpiginous choroidopathy

•Middle age (F = M)

•Eventually bilateral but asymmetrical

•Deep, grey-white lesions with hazy borders

•Initially peripapillary and at posterior pole then outward spread

•Mild vitritis

Serpiginous choroidopathy

•Treatment - steroids and immunosuppressive agents

•Course - chronic-remittent

•Complications - macular scarring

•Prognosis - poor

Residual scalloped, punched-out areas

UVEAL TUMOURS

1.Iris melanoma

2.Iris naevus

3.Ciliary boy melanoma

4.Choroidal melanoma

5.Choroidal naevus

6.Choroidal haemangioma

•Circumscribed

•Diffuse

7.Choroidal metastatic carcinoma

8.Choroidal osseous choristoma

9.Melanocytoma

Iris Melanoma

1.Very rare - 8% of uveal melanomas

2.Presentation - fifth to sixth decades

3.Very slow growth

4.Low malignancy

5.Excellent prognosis

Iris melanoma

	• Usually pigmented nodule at	• Occasionally non-pigmented
	least 3 mm in diameter
		• Surface vascularization
	• Invariably in inferior half of iris

• Angle involvement may cause	• Pupillary distortion, ectropion
glaucoma	uveae and cataract

Differential diagnosis of iris melanoma



Large iris naevus distorting	Leiomyoma	Adenoma of pigment
pupil	Leiomyoma	epithelium
pupil		epithelium


Primary iris cyst	Ciliary body melanoma	Metastasis to iris
Primary iris cyst	eroding iris root	Metastasis to iris
	eroding iris root

Treatment of iris melanoma


Small tumour	Angle invasion by tumour	Non-resectable tumour
- broad iridectomy	- iridocyclectomy	- radiotherapy or enucleation

Iris naevus

Typical

Diffuse

•	Pigmented, flat or slightly elevated	•	Obscures iris crypts
•	Pigmented, flat or slightly elevated
•	Diameter usually less than 3 mm	•	May cause ipsilateral hyperchromic
•	Occasionally mild distortion of pupil and		heterochromia
•	Occasionally mild distortion of pupil and
	ectropion uvea	•	May be associated with Cogan-Reese
			syndrome

Ciliary body melanoma

•Rare - 12% of uveal melanomas

•Presentation - 6th decade

•May be discovered by chance

• Prognosis - guarded

Signs of ciliary body melanoma

• Sentinel vessels

• Extraocular extension

• Erosion through iris root	•	Lens subluxation or cataract
• Erosion through iris root
	•	Retinal detachment

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