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Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001

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Circumscribed choroidal haemangioma

Presentation - adult life

Dome-shaped or placoid, red-orange mass

Commonly at posterior pole

Between 3 and 9 mm in diameter

May blanch with external globe pressure

Surface cystoid retinal degeneration

Exudative retinal detachment

Treatment - radiotherapy if vision threatened

Diffuse choroidal haemangioma

Typically affects patients with Sturge-Weber syndrome

Can be missed unless compared with normal fellow eye as shown here

Diffuse thickening, most marked at posterior pole

Choroidal metastatic carcinoma

Most frequent primary site is breast in women and bronchus in both sexes

 

 

 

 

Fast-growing, creamy-white,

Deposits may be multiple

 

placoid lesion

 

 

Most frequently at posterior pole

Bilateral in 10-30%

 

 

 

 

Choroidal osseous choristoma

Very rare, benign, slow-growing ossifying tumour

Typically affects young women

Orange-yellow, oval lesion

Well-defined, scalloped, geographical borders

Most commonly peripapillary or at posterior pole

Diffuse mottling of RPE

Bilateral in 25%

Melanocytoma

Affects dark skinned individuals

Usually asymptomatic

Most frequently affects optic nerve head

Black lesion with feathery edges

RETINOBLASTOMA

1.Important facts

2.Presentation

3.Signs

Endophytic

Exophytic

4.Treatment

5.Poor prognostic factors

6.Histology

7.Differential diagnosis of leukocoria

Important facts

1.Most common primary, malignant, intraocular tumour of childhood (1:20,000)

2.No sexual predilection

3.Presents before age of 3 years (average 3 months)

4.Heritable (40%) or non-heritable (60%)

5.Predisposing gene (RPE 1) on 13q14

Presentations of retinoblastoma

 

 

 

Leukocoria - 60%

Strabismus - 20%

Secondary glaucoma

 

 

 

 

 

 

Anterior segment invasion

Orbital inflammation

Orbital invasion

 

 

 

Early endophyliticretinoblastoma

 

 

White flat lesion

Placoid lesion

 

 

More advanced endophytic retinoblastoma

Friable white mass

Cottage cheese appearance

Fine surface blood vessels

Vitreous seedings

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