Neuroophthalmology I Flashcards
1
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Graves Disease
- A: diffuse goiter
- B and C:periorbital edema, chemosis, scleral injection, and proptosis; the lid retraction in this patient is obscured by periorbital edema
- D:l ocalized dermopathy, occurring as an indurated, noninflamed plaque on the anterolateral aspect of the shin
2
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Sebaceous Carcinoma
- Neoplastic cells with foamy cytoplasm are detected within the epidermis.
3
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Sebaceous Carcinoma
- The patient’s left lower eyelid shows ectropion, and the cornea shows neovascularization
- Pathology shows mild expansion of the conjunctival epithelium due to infiltration by single or small groups of malignant sebaceous cells with large, hyperchromatic nuclei and occasional mitoses. These display little clear cytoplasm reminiscent of sebaceous differentiation
4
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Conjunctiva: trachoma
- Repeated infection with Chlamydia trachomatis causes chronic inflammation, resulting in follicles (Panel A)
- and scarring (Panel B), in the form of white lines, bands, or sheets, in the tarsal conjunctiva of the upper eyelid
- and causing eyelashes to turn inward and abrade the cornea (Panel C)
5
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Pterygium
6
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Normal cornea
7
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Fuchs Dystrophy
- This tissue section is stained by periodic acid-Schiff to highlight the Descemet’s membrane, which is thick.
- Numerous droplike excrescences-guttata protrude downward from Descemet’s membrane.
- Endothelial cell nuclei are not seen.
- Epithelial bullae, not shown in this micrograph, were present, reflecting corneal edema.
8
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Keratoconus
By tracing Bowman’s layer from the right side of the photomicrograph toward the center, one notices a discontinuity in this layer, diagnostic of keratoconus. The epithelial separation just to the left of the Bowman’s layer break resulted from an episode of corneal hydrops, secondary to a break in Descemet’s membrane (not shown).
9
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Glaucoma
- Cupping of optic nerve head in glaucoma.
- This is secondary to axonal degeneration and subsequent loss of axons.
10
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cataract
11
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Uveal Melanoma
- A, Fundus photograph from an individual with a relatively flat pigmented lesion of the choroid near the optic disc.
- B, Fundus photograph of the same individual several years later; the tumor has grown and has ruptured through the Bruch membrane.
12
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Uveal melanoma
- C, Gross photograph of a choroidal melanoma that has ruptured the Bruch membrane. The overlying retina is detached.
- D, Epithelioid melanoma cells associated with an adverse outcome.
13
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Retinoblastoma
- A, Gross photograph of retinoblastoma.
- B, Tumor cells appear viable when in proximity to blood vessels, but necrosis is seen as the distance from the vessel increases. Dystrophic calcification (dark arrow) is present in the zones of tumor necrosis. Flexner-Wintersteiner rosettes—arrangements of a single layer of tumor cells around an apparent “lumen”—are seen throughout the tumor, and one such rosette is indicated by the white arrow.
14
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Hypertensive retinopathy
- . A, The wall of the retinal arteriole (arrow) is thick. Note the exudate (e) in the retinal outer plexiform layer.
- B, The fundus in hypertension. The diameter of the arterioles is reduced, and the color of the blood column appears to be less saturated (copper wire–like). If the wall of the vessel were thicker still, the degree of red color would diminish such that the vessels might appear clinically to have a “silver-wire” appearance. In this fundus photograph, note that the vein is compressed where the sclerotic arteriole crosses over it.
15
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Hypertensive retinopathy
cotton-wool spot
16
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Diabetic retinopathy
thickening of cilliary body
17
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Diabetic Retinopathy
18
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Optic Glioma
- B, Optic nerve glioma seen on axial computed tomography (CT) scan. Although the tumor is clearly seen on the CT scan, magnetic resonance imaging is preferred to monitor for extension of tumor into brain.
- C, Histopathologic appearance of a low-grade astrocytoma of the optic nerve.
19
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End stage phthisis bulbi
