Pathology & Tumors Flashcards
Angle recession
A tear between the longitudinal and Circular fibers of the ciliary muscle | Rupture of the face of the ciliary body
Cyclodialysis
Disinsertion of the longitudinal muscles of the ciliary body from the scleral spur
Thickness of choroid
- 25 mm Posterior pole
0. 10 to 0.15 mm Anterior and peripheral
Sudden appearance of multiple seborrheic keratoses
Leser-Trelat sign - May indicate the presence of cancer, G.I. adenocarcinoma
Hereditary disease with multiple sebaceous adenoma’s
Muir-Torre - Multiple sebaceous neoplasms In conjunction with a visceral malignancy (G.I. or GU)
Colloidal iron stains
Glycosaminoglycans blue (macular corneal dystrophy) dame as Alcian blue
Scleritis frequently occurs in this condition resulting in zonal inflammatory reaction of histiocytes and lymphocytes
Rheumatoid arthritis
COMS large melanoma trial conclusion
Compared enucleation alone Versus external beam radiation therapy after enucleation = radiotherapy does not impact overall survival
COMS medium melanoma conclusion
Enucleation versus iodine 125 brachytherapy = all cause mortality and Mets equal at 5 years
COMS small melanoma trial conclusions
Melanoma specific mortality at 5 years = 1%
Growth with thicker, orange pigmentation without Drusen or with “hot spots”/hyperfluoresence on FA
Project and synapse in the LGN
Ganglion cell layer
Peter’s anomaly Associations
> 50% systemic, >50% B/L - axenfeld-Rieger, congenital Bella, MLS, Pfieffer, Kivlin, trisomy 13-15,
PAM with atypical risk of progression
50% chance of transforming to malignant melanoma
NF 2 associated ON lesion
ON meningioma
Histopathology of a neurofibroma
Spindle shapes cells within dermis - seen in NF type 1 or 2
80% cases of sclerocornea
Cornea plana (AR most severe but half are sporadic)
Origin of: Corneal stroma, corneal endothelium, iris stroma, sclera
Neural crest
Origin of corneal epithelium, lacrimal system, lens
Surface ectoderm
Origin of iris pigmented epithelium, nonpigmented epithelium, iris sphincter/dilator, RPE, neuroretina, optic nerve
Neuroectoderm (RPE is only pigmented tissue not from neural crest)
Origin of temporal portion of sclera and fibers of extra-ocular muscles
Mesoderm
Origin of most of iris (sphincter, dilator, stroma), EOM fibers, temporal sclera, vascular endothelium, vitreous
Mesoderm
FA shows slow filling of lesion with pooling of dye in upper part of vascular space.
Retinal cavernous hemangioma
FA shows rapid AV phase with massive leakage of due into tumor
Capillary hemangioma
“Iron filings” deposits on anterior lens capsule
Pseudoexfoliation
DDx for retained lens nucleus
Trisomy 13
Rubella
Lowe
M/c presenting signs with Rb <5 yo
Leukocoria + strabismus
M/c presenting signs with Rb > 5 yo
Leukocoria and decreased vision
Non-ocular tumors in Rb survivors outside field of radiation
Osteosarcoma and malignant melanoma
Non-ocular tumors in Rb survivors that arise within field of radiation
Osteosarcoma and fibrosarcoma
Middle aged Caucasian woman Presenting with unilateral glaucoma ,with slightly irregular
ICE syndrome
Features of choroidal metastasis
Flat and ill-defined
Yellow white to gray yellow
Leopard spotting pattern - Overlying RPE changes
Redundant peri-Umbilical skin
Axenfeld-Rieger syndrome
Sunflower cataract
Wilson disease
Common ocular finding in patients with chronic uveitis from JIA
Band keratopathy
Most common cause of vision loss in JIA
Cystoid macular Edema
Most choroidal melanotic tumors that are melanomas are greater than this thickness
3 mm
Risk factors for choroidal lesion being a melanoma
Hotspots on fluorescein angiography Orange pigment Large size Juxtapapillary location Absence of drusen/RPE changes Homogeneity on ultrasound
A patient with multiple basal cell carcinoma is at risk for
Basal cell nevus syndrome - medulloblastoma or fibrosarcoma
Cowden disease
Multiple trichilemmomas: breast cancer + Fibrous hamartomas of the G.I. tract, thyroid, breast
BIGH3 gene (TGFB1 at chromosome 5q31)
Granular dystrophy (AD)
Mechanism of PSC cataract
Posterior migration of lens Epithelial cells from equator, swell to 5x size = bladder or Wedl cells
Prognostic info about eye survival in RN
Reese Ellsworth classification
Schwannoma Association
NF2>NF1
25 yo Nevus flammeus and elevated IOP
Sturge-Weber
Cerebellar and renal hemangioblastomas
Von Hippel Lindau
21 yo seizures, red patches on face, rough skin patches on back
Tuberous sclerosis
Describe ciliary body epithelium
2 layers - inner nonpigmented layer (faves posterior chamber) and outer pigmented layer (faves ciliary muscle). Corresponds to retina layers is RPE
Protein responsible in TGFB1 mutations
Keratoepithelin
TGFB1 corneal dystrophies
Epithelial basement membrane dystrophy Reis- Buckler Thiel-Behnke Lattice types 1 and 3 Granular types 1 and 2 (avellino)
Curly fibers on EM
Thiel-Behnke (TBCD)
Uveal tract attaches to sclera at 3 points
Sclera spur
Internal openings of vortex veins (internal ostia)
Peripapillary tissue
HLA-DR4
Vogt-Koyanagi (VKH) disease
HLA-DR2
Pars planitis
HLA-B51
Bechets
HLA-A29
Birdshot chorioretinitis
Glial cells
Muller cells + fibrous astrocytes (retinal scar formation after laser)
Dense black clumps in retinal scars result from..
RPE cells undergo fibrous metaplasia
Pseudo Roth spot
Retinal lesion in leukemia - White centered hemorrhages (Most common clinical sign in leukemia)
Consists of most newly formed lens fibers
Cortex
Thickness of anterior and posterior lens capsules
12–21 µm
2–9 µm
PITX2 gene
Axenfeld-rieger
AD, glaucoma in 50% of cases
Axenfeld Rieger
Adenfeld anomaly versus Axenfeld syndrome
Schwalbe’s line Is anteriorly displaced
Syndrome - Trabecular meshwork abnormalities and glaucoma
KRT3 or KRT12
Meesmans corneal dystrophy - epithelium and basement membrane
CD45
Lymphocyte marker
Redundant epithelial basement membrane and encysted Degenerated epithelial cells
Anterior basement membrane dystrophy - Map – dot – fingerprint
Rosenthal fibers found in
Optic nerve glioma (Degenerating eosinophilic filaments)
Psammoma body
ON meningioma and pituitary prolactinoma
ICK is Caused by
Streptococcus viridans
Remnant of the hyaloid artery Of the primary vitreous at its site of attachment
Mittendorf dot
Tunica vasculosa lentis
Infero nasal
Indicate subsequent invasive melanoma and 75 to 90 percent of Patients
Pagetoid spread or full thickness epithelial involvement
Most common ocular tumor to spread to the eye via direct extension
Squamous cell carcinoma of the conjunctiva
Type two hypersensitivity reaction to the basement membrane With predominance of mature, differentiated B Lymphocytes or plasma cells with scattered lymphocytes
Ocular cicatricial pemphigoid
Most frequent location of iris melanomas
75% Inferior or inferotemporal
Cause sectoral cataract
Iris melanoma
Location of most common ocular manifestation of sarcoidosis
Uveal tract (Iris)
Staghorn shaped blood channels
Hemangiopericytoma
Age at presentation with known Rb FHx
8 months
(Bilateral 12 mo)
(Unilateral 24)
IL- 6
Inflammatory response
IL-10
Elevated in neoplastic response
Tumor of the nonpigmented ciliary epithelium
Medulloepithelioma
Occurs in 25% of patient’s with NF-1
Plexiform neurofibroma
Occurs with blood in AC + elevated IOP x > 48 hours
Blood staining
Layers of descemet membrane
Anterior banded. Posterior non-banded
How is descemet membrane produced?
Endothelium
Distinguishes neovascular AMD from choroidal osteoma
High amplitude echo on ultrasound 2/2 calcification. Benign bony tumor near ON, may have choroidal neovascularization near macula
Orange yellow with pseudopod margins
Choroidal osteoma
Tertiary vitreous
Zonular fibers
Conjunctival melanoma most commonly metastasizes to ..
Head and neck LN (submandibular pre-auricular)
Uveal melanoma m/c first metastasize to
Liver
Granulomatois inflammation with co-existing chronic sinusitis and saddle nose deformity.
GPA granulomatosis with polyangiitis
Liquified lens cortical material
Morgagnian cataract
Common etiology of PAS
NVA - ie CRVO (35% incidence of NVI/NVA at 3 years in non-perfused and 10% in perfused)
Pigmented lesion of palpebral conjunctiva
Most likely malignant
Divides lacrimal gland into palpebral and orbital portion.
Aponeurosis of levator palpebral superioris, always bx superotemporal portion to avoid lacrimal excretory ducts in palpebral portion.
M/c ocular involvement of sarcoidosis
Uveal tract
Anterior - iris (koeppe, busacca, Berlin nodules)
Posterior - chorioretinitis, periphlebitis (“candle wax dripping”) chorioretinal nodules
M/c orbital involvement of sarcoid
Lacrimal gland
Association of limbal dermoid
Goldenhar syndrome
Keratoconus association
Marfans
Histo findings in keratoconus
Breaks in bowman membrane 2/2 bowing of cornea
Hydrops- scrolling of DM
Location dot-blot
Inner nuclear, outer nuclear, inner plexiform
Complication is IOL made of PMMA
❄️ degeneration
Complication of IOLs made of hydrogel
Calcification
Complication of hydrophobic lens
Glistenings
Complication of silicone based IOL after posterior YAG capsulotomy
Calcium oxalate from asteroid hyalosis
Systemic manifestation of Axenfeld-Rieger syndrome
Hypodontia
Redundant periumbilical skin
Maxillary hypoplasia
Hyposoadias
Aniridia
Wilms tumor
Preauricular skin tags
Goldenhar syndrome
Absence of greater sphenoid
Neurofibromatosis
Normal population of melanocytes in basal layer (number)
Every 5th-10th cell
