Term
| Tumour made up of melanin pigmented cells; metastatic |
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Definition
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Term
| term for a non-pigmented melanoma |
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Definition
|
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Term
| benign, tumour-like nodule that is made up of cells and tissue that normally occur that tissue |
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Definition
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Term
| Neoplasm composed of embryonic cells of the tissue/organ |
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Definition
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Term
| Cancer that begins in the skin or tissues that line the body organs |
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Definition
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Term
| Another name for benign choroidal melanoma |
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Definition
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Term
| What may indicate chronicity of a choroidal nevus |
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Definition
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Term
| General shape and elevation of choroidal nevus |
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Definition
| flat/minimally elevated, round or oval |
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Term
| Time when choroidal nevi grow the most |
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Definition
| Before puberty, rare to grow after this time |
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Term
| Choroidal lesions will ___________________ with the red-free filter turned on |
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Definition
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Term
| With what size of a choroidal nevus should one start to suspect malignancy |
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Definition
|
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Term
| How often should you RTC a 2-5DD choroidal nevus |
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Definition
|
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Term
| Name 4 additional tests for evaluating a suspect choroidal nevus |
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Definition
Ultrasound
FA
Photodocument
P32 |
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Term
| Changes in appearance of a choroidal nevus that increase suspicion of malignancy |
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Definition
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Term
|
Definition
| Malignant choroidal melanoma |
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Term
| Average age of incidence of malignant choroidal melanomas |
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Definition
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Term
| Malignant choroidal melanoma is extremely rare in which ethnicity? |
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Definition
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Term
Malignant choroidal melanoma-circumscribed vs. diffuse
Which is more common |
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Definition
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Term
Malignant choroidal melanoma-circumscribed vs. diffuse
Which has worse prognosis |
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Definition
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Term
| Color and elevation of malignant choroidal melanoma |
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Definition
Highly elevated
grayish-green color |
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Term
| Symptoms associated with malignant choroidal melanoma |
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Definition
may be asymptomatic
reduced Vas
visual field defects
photopsia/floaters |
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Term
Malignant Choroidal melanoma unilateral vs. bilateral
Primary lesions are typically ___________________
Secondary lesions are typically _________________ |
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Definition
1. unilateral
2. bilateral |
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Term
| Males with malignant choroidal melanoma commonly have a history of these 2 types of cancer |
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Definition
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Term
| Females with malignant choroidal melanoma commonly have a history of which type of cancer |
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Definition
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Term
| Which is better for visualizing lipofuscin deposits, fluid detachments and dilation of feeder vessels, contact fundus lens or BIO |
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Definition
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Term
| How to differentiate between melanoma and hamartoma |
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Definition
| Transillumination of the sclera- pigmented will not transmit light but the nonpigmented lesions will |
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Term
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Definition
| Will block the fluorescence |
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Term
| Tx options for malignant choroidal melanoma greater than 3 mm thick and larger than 10mm in diameter |
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Definition
Enucleation
Radioactive plaques
Transpupillary Thermotherapy
Local resection
Heavy charged particle irradiation |
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Term
| 3 complications from radioactive plaques |
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Definition
retinopathy
cataracts
vitreous hemorrhages |
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Term
| Compare FANG of benign vs. malnignant lesion |
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Definition
Benign=hypofluorescence
Malignant=hyperfluorescence |
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Term
| Definitions for TFSOM (To Find Small Ocular Melanomas) |
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Definition
T=Thickness >2mm
Subretinal fluid
Symptoms
Orange
Margin touching optic disk |
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Term
| Based on the COMS study results, what is standard treatment for 'large choroidal melanomas.' |
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Definition
| Enucleation, no difference with pre-enucleation radiation |
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Term
| Based on the COMS study results, what is standard treatment for 'medium choroidal melanomas.' |
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Definition
| Same mortality rate for brachytherapy as enucleation, thus most choose brachytherapy so they keep their eye. |
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Term
| A slow-growing, benign, intrachoroidal calcification near the nerve head. |
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Definition
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Term
| Describe the appearance of choroidal osteomas |
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Definition
| yellow-white to orange-red lesions with scalloped edges |
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Term
| Appearance of choroidal osteoma on A scan |
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Definition
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Term
| Appearance of choroidal osteoma on B scan |
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Definition
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Term
| Ciliary Body Malignant Melanomas are usually not visible until they grow very large, what are some other ways they can be diagnosed |
|
Definition
Pressure creates irregular astigmatism
CORECTOPIA
Anterior displacement of lens
Focal opacity in lens
Focal dilation of episcleral vessels
Glaucoma
RD |
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Term
| 2 treatment options for ciliary body malignant melanomas |
|
Definition
Enucleation if large
Sector resection if small-medium |
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Term
| Location of a melanocytoma |
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Definition
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|
Term
T or F
Melanocytomas usually involve the superior part of the nerve head |
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Definition
False
Usually the inferior part is involved |
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|
Term
T or F
Melanocytomas are almost always devastating to vision |
|
Definition
False
75% have no visual reduction, if there is any it is minimal |
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Term
| Main differential diagnosis for a melanocytoma |
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Definition
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Term
| Which test is used to differentiate a malignant melanoma from a melanocytoma |
|
Definition
Fluorescein angiography
Malignant=hyperfluorescence
Melanocytoma blocks the dye, no vascular abnormalities |
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Term
| Another name for a secondary tumor |
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Definition
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Term
| What is one possible reason that ocualr tissues are relatively common sites for metastasis |
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Definition
| Vascular nature of the eye |
|
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Term
| What proportion of metastatic carcinoma of the choroid are bilateral |
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Definition
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Term
| Common site for the primary tumour in cases of metastatic carcinoma |
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Definition
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Term
| Describe appearance of metastatic carcinoma of the choroid |
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Definition
Generally posterior pole
oval, flat/slightly elevated
creamy white-yellow-gray |
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Term
| Primary symptom of metastatic carcinoma of the optic nerve |
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Definition
|
|
Term
| Prognosis for metastatic carcinoma of the optic nerve |
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Definition
| Poor, avg survival 10 months |
|
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Term
| What is the most common primary ocular tumour in children |
|
Definition
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Term
| Retinoblastoma is a common ocular tumour, second only to _____________________ |
|
Definition
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Term
Retinoblastoma
Usually solitary or multiple? |
|
Definition
| Usually multiple tumours, average of 5 |
|
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Term
| Mortality rate of retinoblastoma |
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Definition
|
|
Term
T or F
The majority of cases of retinoblastoma are due to germinal mutations and thus can be passed on to offspring |
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Definition
| False, 25% can be passed on, the other 75% are somatic mutations and cannot be passed on |
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Term
| What is the risk of having a child with retinoblastoma if there are already 2 affected children in the same family |
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Definition
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Term
| A survivor of hereditary retinoblastoma has what chance of having a child with retinoblastoma |
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Definition
|
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Term
| 2 subjective signs of retinoblastoma |
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Definition
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Term
| Why may Retinoblastoma be reflective on ultrasound |
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Definition
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Term
Treatment of Retinoblastoma
Photocoagulation is an option for what size of tumours |
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Definition
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Term
Treatment of Retinoblastoma
Irradiation is an option for what size of tumours |
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Definition
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|
Term
Treatment of Retinoblastoma
Cryotherapy is a treatment for what size of tumours |
|
Definition
|
|
Term
| Description of type of Retinoblastoma that has the best prognosis |
|
Definition
Group I
Small <4DD, behind equator |
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Term
| What is the name of the ciliary body equivalent to retinoblastoma |
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Definition
| Embryonic Medulloepithelioma |
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Term
| Which layer of the ciliary body is involved in embryonic medulloepithelioma |
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Definition
| non-pigmented epithelial layer of the ciliary body |
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Term
| Name 4 associated findings of medulloepithelioma |
|
Definition
Glaucoma
Cataracts
Iritis
rubeosis |
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Term
| Multiple gray to white fluffy mass of inner surface of ciliary body |
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Definition
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Term
| Which ocular tumour is usually associated with trauma to the eye or post inflammation |
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Definition
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|
Term
| What does CHRPE stand for |
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Definition
| Congenital Hypertrophy of Retinal Pigment Epithelium |
|
|
Term
| Will CHRPE disappear with red-free filter? |
|
Definition
| No, RPE lesions do not disappear with red-free filter, choroidal lesions will |
|
|
Term
|
Definition
dark grey, black
distinct edges
variable size
may be single or multiple |
|
|
Term
| 4 'causes' of RPE Hyperplasia |
|
Definition
Insult/Trauma to retina
Chorioretinal inflammations
scars
Choroidal neo |
|
|
Term
| Mechanism of RPE Hyperplasia |
|
Definition
| Invasion of RPE into sensory retina |
|
|
Term
| Appearance of RPE Hyperplasia |
|
Definition
| Jet black irregular pigmentation |
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Term
| Cerebral Angiomatosis aka______________________ |
|
Definition
|
|
Term
| Describe Von Hippel-Lindau Dz |
|
Definition
| A condition that predisposes patients to benign and malignant vascular tumours, specifically of the retina, CNS, liver, kidneys, pancreas and spleen |
|
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Term
| Describe the vasculature involved in cerebroretinal angiomatosis tumours |
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Definition
Vessels are 2-3X larger than normal and tortuous
Usually involves both afferent and efferent vasculature |
|
|
Term
Cerebroretinal Angiomatosis
What proportion of ocular manifestations are bilateral |
|
Definition
|
|
Term
Cerebroretinal Angiomatosis
More common location for ocular tumours |
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Definition
| Mid-peripheral retina but can be found anywhere |
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|
Term
Cerebroretinal Angiomatosis
describe the ocular tumour |
|
Definition
| Capillaries growing in disarray with associated glial proliferation |
|
|
Term
Cerebroretinal Angiomatosis
Ocular complications of the tumours |
|
Definition
Hemorrhage/hard exudation of the tumour
Secondary glaucoma
Retinal Detachment |
|
|
Term
Cerebroretinal Angiomatosis
Systemic complications |
|
Definition
Cerebral, cerebellum and spinal cord tumours
visceral organ tumours (kidneys, pancreas etc.) |
|
|
Term
| Encephalotrigeminal Angiomatosis aka____________________ |
|
Definition
|
|
Term
| 3 types of angioma associated with Sturge-Weber syndrome |
|
Definition
Intracranial angioma
Facial Angioma
Choroidal angioma |
|
|
Term
| Which nerves are often involved in Sturge-Weber |
|
Definition
| 1st and 2nd branches of trigeminal nerve |
|
|
Term
| What is another term for the flat venous hemangioma associated with Sturge-Weber |
|
Definition
| Nevus Flammeus or Port Wine Stain |
|
|
Term
| Why might a diffuse choroidal hemangioma be missed |
|
Definition
| Because the entire fundus is deep red in color , may only be noticed if compared to the other eye |
|
|
Term
Choroidal Hemangioma associated with Sturge Weber
Localized or diffuse? |
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Definition
| Tend to be diffuse in Sturge-Weber |
|
|
Term
| Sturge-Weber syndrome-which additional ocular manifestation is a primary concern |
|
Definition
| Congenital glaucoma (30% develop) |
|
|
Term
| Involvement of what structure increases likelyhood of development of glaucoma in Sturge-Weber syndrome |
|
Definition
|
|
Term
| Why are arteriovenous malformations not true phacomatoses? |
|
Definition
True phacomatoses involve retina, CNS AND skin
This only involves the retina and CNS |
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|
Term
| What is the origin/cause of arteriovenous malformations |
|
Definition
| Embryonic origin-failure of the differentiation of the vascular plexus |
|
|
Term
| Describe arteriovenous malformations |
|
Definition
| direct communication of arteries and veins without a capillary bed , these vessels are markedly dilated and tortuous |
|
|
Term
| Symptoms of Arteriovenous Malformation |
|
Definition
| typically asymptomatic but can cause hemorrhages |
|
|
Term
| Systemic manifestations of arteriovenous malformations |
|
Definition
| similar lesions can occur in the brain, hemorrhage can cause epilepsy |
|
|
Term
| Tuberous Sclerosis aka ___________________ |
|
Definition
|
|
Term
| Cutaneous manifestations of Tuberous Sclerosis |
|
Definition
Sebaceous Adenoma
Achromic Nevi
Shagreen Patch |
|
|
Term
| Ocular Manifestations of Tuberous Sclerosis |
|
Definition
Small conjunctiva tumours
hypopigmented iris spots
Astrocytoma |
|
|
Term
| Describe the sebaceous adenomas found in Tuberous Sclerosis |
|
Definition
| Called Angiofibromas, they are lesions that vary in size and shape, highly vascularized, found area the nose and lips |
|
|
Term
|
Definition
| hypopigmented skin patches on trunk and limbs that resembles ash leaves |
|
|
Term
| Describe the Shagreen patch associated with Tuberous Sclerosis |
|
Definition
| A diffuse, fibrous thickening that has an orange peel appearance, usually located on the back |
|
|
Term
| Describe appearance of astrocytoma associated with Tuberous Sclerosis |
|
Definition
| Gray-white raised, nodular lesions that resemble a mulberry, 0.5-1DD in size, usually near ONH |
|
|
Term
| Primary symptom of astrocytoma |
|
Definition
|
|
Term
| Systemic manifestations of Tuberous Sclerosis |
|
Definition
Astrocytic tumours can develop in the brain and block CSF drainage or cause focal defects. 80% suffer epilepsy, 60% develop some mental retardation
Tumours may also develop in kidney, thyroid and heart |
|
|
Term
| 3 Cutaneous Manifestations of Neurofibromatosis |
|
Definition
Café au lait spots
Plexiform neurofibromas
Fibroma molluscum |
|
|
Term
| Café au lait spots are associated with which diseasse |
|
Definition
| Neurofibromatosis (Von Recklinghausen's Disease) |
|
|
Term
| Describe the number and size of Café au Lait spots that almost guarantees the manifestation of Neurofibromatosis |
|
Definition
| 6 or more spots exceeding 1.5 cm in diameter |
|
|
Term
| subcutaneous tumours originating in the Schwann cells of peripheral nerves |
|
Definition
| Plexiform neurofibromas (Neurofibromatosis) |
|
|
Term
| how do plexiform neurofibromas cause elephantiasis neuromatosis |
|
Definition
| They cause hypertrophy of the surrounding skin |
|
|
Term
| CNS Manifestations of Neurofibromatosis |
|
Definition
| Multiple tumours of brain, spinal cord, meninges and nerves |
|
|
Term
| Manifestation of Neurofibromatosis in the lids |
|
Definition
| Produces s-shaped lids with partial to complete ptosis |
|
|
Term
| How may neurofibromatosis result in proptosis |
|
Definition
Orbital tumours or optic nerve gliomas can cause the proptosis
May also be due to congenital absence of portion of the sphenoid |
|
|
Term
| How may neurofibromatosis manifest on the iris |
|
Definition
| Formation of tumours that look like tan nodules or nevi, these increase in number with age and cause heterochromia |
|
|
Term
| What ocular disease may manifest due to Neurofibromatosis |
|
Definition
| Congenital unilateral glaucoma |
|
|
Term
| Treatment of neurofibromatosis |
|
Definition
| surgical removal of the tumours, possibly irradiation of the optic nerve gliomas |
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|
