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Peripapillary choroidal melanomas. Extension along the optic nerve and its sheaths
Archives of Ophthalmology (Chicago, Ill. : 1960)
|March 1, 1978
Summary
Peripapillary melanomas frequently invade the optic nerve and retina, often leading to blindness and glaucoma. Surgical excision of a significant optic nerve segment is recommended for these cases.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Peripapillary melanoma is a rare intraocular tumor.
- Understanding its behavior and prognostic factors is crucial for patient management.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of peripapillary melanoma.
- To identify factors influencing tumor extension and patient prognosis.
Main Methods:
- Retrospective review of 26 cases of peripapillary melanoma.
- Analysis of histopathological features, tumor extension patterns, and clinical outcomes.
Main Results:
- 80.8% of cases showed extension into the optic nerve or meninges.
- Tumors invading the optic nerve were often necrotic, mixed/epithelioid cell type, invaded retina, and occurred in blind eyes with secondary glaucoma.
- Extension into the subarachnoid space correlated with peripapillary location.
- Orbital extension significantly impacted prognosis.
Conclusions:
- Peripapillary melanomas have a high rate of optic nerve and retinal invasion.
- Prognosis is strongly linked to orbital extension.
- Enucleation with extensive optic nerve resection is advised for these tumors.