الفهرس 
Anatomy of the choroidOnly 14 pages are availabe for public view
 |  | from | 224 |  |  |
| | | from | 224 | | |
Abstract
Melanoma of the choroid is the most common primary intraocular malignant neoplasm. It is predominantly a disease of older individuals. It has a well-documented capacity to metastasize and result in host death. The most prevalent site of metastasis is the liver.
Other tumours of the choroid include hemangioma, osteoma, melanocytoma, nevus, and metastases.
Histologically, choroidal melanomas may be composed of spindle A cells, spindle B cells, epithelioid cells, or various combinations of spindle and epithelioid cells (mixed-cell melanoma).
A variety of neoplastic (e.g. choroidal nevus, choroidal hemangioma, choroidal metastases) and non-neoplastic choroidal lesions (e.g. choroidal detachment, macular diseases, posterior scleritis) can clinically simulate choroidal melanoma. The most common simulating lesion is the nevus. The mis-diagnosis of these lesions for choroidal melanoma has been diminished in the recent years due to the development of more reliable diagnostic techniques.
The diagnosis of choroidal tumors can be made by slit lamp biomicroscopy or indirect ophthalmoscopy. However, the diagnosis must be confirmed by the use of ancillary studies such as fluorescein angiography, indocyanine green angiography, CT, MRI, radioactive phosphorus uptake and fine needle aspiration biopsy.
Management of choroidal melanoma depends on several factor such as size, site, age of the patient, general health, psychological state and condition of the other eye.
Small melanoma should be observed by fudus photography and ultrasonography.
Radiotherapy can be used in certain ways such as brachytherapy or charged particle irradiation can be used for medium sized melanomas for retaining of useful vision.
Transpupillary thermotherapy can be used for small and medium sized melanomas also using infrared light delivered by diode laser through the pupil.
Photodynamic therapy can be used also as primary treatment modality with application low intensity non thermal light.
Microsurgical resection can be used also either trans-scleral or through endo-resection with localized removal of the tumour.
Enucleation still can be done for some selected cases such as large melanomas complicated by secondary glaucoma.
Exentration can be done in massive extraocular extension or recurrence after enucleation.
Choroidal nevus is a common benign tumor of the choroid. It infrequently undergoes malignant transformation. The majority of them do not require treatment. Lesions associated with subfoveal serour retinal detachment can be managed by photocoagulation. Suspicious nevi monitored closely by periodic observation to detect maliganat transformation as early as possible.
Choroidal metastasis is the most common malignant tumor in the eye which is most commonly come from breast carcinoma in women and lung carcinoma in men. It can be treated by radiotherapy and chemotherapy depending on the primary origin.
Choroidal hemangiomas are uncommon intraocular tumor that could happen as a diffuse type or circumscribed. It can be treated by radiotherapy or photocoagulation.
Choroidal osteoma is a benign ossifiying tumor found in young females unilateral and found in the juxtapapillary area commonly associated with neovascularization and subretinal fluid. Loss of vision is variable and systemic prognosis is good.