Departments of Ophthalmology, Neurology, and Neurological Surgery
The George Washington University Medical Center
Atlas of Intraocular Tumors, Jerry A. Shields, MD, and Carol L. Shields, MD, Lippincott Williams & Wilkins, Philadelphia, PA, 1999. ISBN: 0721642683, Price: $239.00
Scope: This is a comprehensive picture atlas, part of a three-part series on ocular tumors by the authors. They are recognized as ultimate authorities on the subject of ocular tumors and this work is a collective presentation of their 25 years of experience in this field. The focus of the book is to be a ready reference for recognition of various intraocular tumors and related conditions. A slide collection of cases is used to achieve this goal. A concise description of both the rare and the common tumors with clinical presentation, clinical examination, histopathology, and references is given. The predominant emphasis is on the clinical presentation and pathology of pigmented tumors, which reflects the authors' deep interest in the subject. The design of the book allows the ophthalmologist to correctly diagnose the lesions so that appropriate therapy and management are instituted in a timely way.
Contents: The book is organized into three parts. The first part covers tumors of the uveal tract; the second deals with tumors of the retina and optic disc; and the last part encompasses miscellaneous intraocular tumors. The first section is the largest part and contains 14 chapters describing congenital uveal lesions, iris nevi, iris cysts, and iris melanomas. Five chapters are devoted solely to posterior uveal melanomas and their clinical features, pathology, diagnosis, management, and those tumors simulating posterior uveal melanomas. In the second part, two chapters deal with retinoblastoma and simulating lesions. The other two chapters cover vascular lesions and glial tumors of the retina and optic disc. Finally, the last and shortest section of the atlas contains four chapters that describe congenital retinal pigment epithelium (RPE) hypertrophy and hyperplasia, combined hamartomas of the retina and RPE, and adenoma and adenocarcinoma of the retina and RPE. Other chapters detail tumors of the nonpigmented ciliary epithelium, intraocular lymphoid tumors, and leukemia. Finally, a rather short chapter covers the surgical approaches to intraocular cases.
Strengths: The atlas displays more than 1482 illustrations and photographs culled from the authors' experience in handling cases of neoplasia from around the globe. These clinical and histopathologic photographs are, with few exceptions, of excellent quality and leave the reader feeling comfortable with the characteristic appearance and presentation of these entities. Moreover, some lesions are supplemented with detailed pictures of the fundus, anterior segment, radiographic images, fundus illustrations, fluorescein angiograms, and external photographs.
Deficiencies: The last chapter (22), describing the various surgical techniques used in the management of intraocular tumors, deals with the topic in a rather cursory manner. Some of the illustrated surgical approaches are deficient in scope. A broader review of surgical techniques and their references is recommended for the reader.
Recommended audience: Ophthalmology residents, practicing ophthalmologists, and ocular oncologists. I have found it helpful in several difficult cases I recently managed.
Critical appraisal: At your fingertips is a detailed compendium of the presenting features and appearance of intraocular tumors composed by authoritative sources. This belongs in the library of every ophthalmology training program.