new condensed eye Flashcards
What is the most common intraocular tumor of the eye?
Melanoma metastasis
What are the two genes associated w uveal melanoma?
GNAQ and GNA11
What morphology in melanoma metastasis has the worst prognosis?
Epithelioid –> spherical w greater cytological atypicality
Morphology of melanoma in eye
Spindle:fusiform w large nuclei, prominent nucleoli, infiltrating plasma cells, and lymph
Where will uveal melanoma spread first? What is the 5 and 10 yr survival rate?
Liver
5: 80%
10: 40%
What is an important factor to consider w corneal transplants?
Lacks blood vessels and lymphatics, so lacks rejection!
risk of rejection will increase w stromal vascularization and invasion
What is the more common type corneal transplant rejection?
non-immunological like the loss of endothelial cells and subsequent corneal edema
What are cataracts?
corneal opacities that may be congenital or acquired
What are RFs for cataracts? (6)
DM Wilson dz Atopic dermatitis Drugs - esp CS Radiation Trauma
What is a posterior subcapsular cataract?
migration of lens epithelium posterior to lens equator
What is a morgagnian (hypermature) cataract?
Lens cortex liquifies
Phacolytic glaucoma
Proteins from the liquified cortex can leak through the lens capsule and clog trabecular meshwork, leading to increased intraocular pressure
what’s glaucoma
collection of dz’s w distinct changes in visual field and cup of optic nerve
-associated w increased IOP
Open angle glaucoma
have open access to trabecular meshwork and an increased resistance to aqueous outflow – increases IOP!
Primary open angle glaucoma
most common form
MYOC mutations for juveniles and adults
Secondary open angle glaucoma
Pseudoexfoliation is most common form w deposition of fibrillary material thru the ant. segment
LOX1 gene
angle closure glaucoma
periph zone of iris will adhere to trabecular meshwork and impede outflow of FLD
Risk factors for glaucoma
age race (AA and hispanic) FH DM HTN trauma prolonged CS use!!!
Retinoblastoma basics
most common primary intraocular malignancy of childhood
neoplastic origin from nucleated layers of retina
Chr 12 longarm; 13q14 = RB
How are do you get retinoblastoma
Start w one mutated gene; normal gene should suppress but one abnormal gene can be unstable and lead to mutation of normal gene
If due to germline mutation, likely bilateral
What are the most common sx of RB?
leukocoria (white pupillary reflex) strabismus, and ocular inflammation
Pseudohypopyon
Cells shed into ant chamber in retinoblastoma and can aggregate and form nodules on iris
Where does RB metastasize?
skull bones, distal bones, brain, spinal cords, LN, abdominal viscera
What is the most common route of escape for RB
optic nerve –> extends into brain. poor prognosis.
How would RB invade the entire CNS
cells have access to leptomeninges and SA space
Retinoblastoma histo
round, oval, or spindle shaped hyperchromatic nuclei w scant cytoplasm.
has high mitotic rate
Flexner wintersteiner
single row of eosinophilic columnar cells w peripherially oriented nuclei around the central lumen lined w refractile structure like external limiting membrane
characteristic of RB
Homer wright
less common in RB. lumen filled w tangle of eosinophilic cytoplasmic processes
Fleurette
curvilinear clusters of cells composed of rod and cones inner segments
attached to abortive outer segments
