Seven Deadly Sins in Ocular 1: Missing the Tumor Not performing - PowerPoint PPT Presentation

12/2/2016 Seven Deadly Sins in Ocular 1: Missing the Tumor Not performing adequate ophthalmoscopy Oncology 70F Bertil Damato MD PhD UCSF No financial declarations 1: Missing the Tumor 1: Missing the Tumor Not performing adequate ophthalmoscopy Not performing adequate ophthalmoscopy N = 180 C/O Michael Deiner 1

12/2/2016 1: Missing the Tumor 1: Missing the Tumor Not imaging adequately Not interpreting images correctly Retinal Lymphoma Choroidal haemangioma Feb 2015 AutoFluorescence Panoret Sep 2016 Optical Coherence Tomography Topcon Optos 1: Missing the Tumor 1: Missing the Tumor Not taking a proper history Not taking a proper history …with a pinch of salt. 2

12/2/2016 1: Missing the Tumor 1: Missing the Tumor Not considering the diagnosis Not considering the diagnosis www.oculonco.com 2: Not communicating with the 2: Not communicating with the Not mentioning nevi and other ‘ trivial ’ Not explaining meaning of ‘suspicious mole ’ patient patient findings 34F 3

12/2/2016 2: Not communicating with the 2: Not communicating with the patient patient Not telling patient of your diagnosis of Not helping patients remember what they’re melanoma told 3: Giving bad news badly 4: Giving bad advice Not showing compassion ‘Your baby has only a one-in-a-million chance of getting a retinoblastoma like yours.’ (Pediatrician) 4

12/2/2016 5: Performing dangerous 5: Performing dangerous biopsy biopsy Vitreous biopsy in a child Incisional biopsy of nodular conjunctival melanoma c/o Dr. Doris Hadjistilianous, Siena, Italy 6: Not performing essential 6: Not performing essential biopsy Primary acquired melanosis biopsy Unilateral conjunctivitis/blepharitis 5

12/2/2016 ‘Vitritis ’ unresponsive to steroids 6: Not performing essential biopsy 7: Treating cancer without essential resources Jan 13 Floaters Multiple specialists Sep 13 Vitritis Predforte No improvement Refer to Proctor Vitritis OD Ret lesions OS Inves -ve Apr 14 Biopsy: failed May 14 Ref to Oc Onco Ref to Hem Onco No CNS lymphoma Sep 14 Enlargement of lesions Oct 14 +ve vit biopsy = Lymphoma Ref to Hem Onco Rx: High dose methotrexate Apr 15 Resolution OU 20/40 OD 20/50 OS Cataract OU 6