Ocular Pathology

Bridge the gap between ophthalmology and pathology with the 8th Edition of this comprehensive, easy-to-understand reference from Drs. Myron Yanoff and Joseph W. Sassani. Designed to keep you up to date with every aspect of the field, from current imaging techniques to genetics and molecular biology to clinical pearls, Ocular Pathology provides the concise yet complete information you need for board exams and clinical practice. Includes new coverage of genetics and molecular biology , complications in diabetes mellitus, and the role of new drugs and other treatments for macular degeneration. Covers the latest imaging techniques , including optical coherence tomography (OCT), anterior segment OCT (AS-OCT) and OCT-angiography. Contains new images throughout that provide updated correlations between pathological and clinical aspects of each disorder. Clinicopathological correlations are presented with side-by-side image comparisons to make clinical pearl boxes even more useful. Features more than 1,900 illustrations from the collections of internationally renowned leaders in ocular pathology. Presents information in a quick-reference outline format - ideal for today's busy physician. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. Cover Ocular Pathology Copyright Page Foreword Forewords to the First Edition Preface Acknowledgments Dedication 1 Basic Principles of Pathology Inflammation Definition Causes Phases of Inflammation Staining Patterns of Inflammation Immunobiology Background Cellular Immunity (Delayed Hypersensitivity) Humoral Immunoglobulin (Antibody) Autoimmunity and Autoinflammation Immunohistochemistry Immunodeficiency Diseases Transplantation Terminology Cellular and Tissue Reactions Hypertrophy Hyperplasia Aplasia Hypoplasia Metaplasia Atrophy Dysplasia Neoplasia Degeneration and Dystrophy Necrosis (Table 1.11) Apoptosis Calcification Autolysis and Putrefaction Pigmentation Growth and Aging Epigenetics and Ocular Disease Modern Molecular Pathology Diagnostic Techniques Concluding Comments Bibliography Inflammation Immunobiology Cellular and Tissue Reactions Epigenetics and Ocular Disease Modern Molecular Pathology Diagnostic Techniques 2 Congenital Anomalies Phakomatoses (Disseminated Hereditary Hamartomas) General Information Angiomatosis Retinae (von Hippel’s Disease [VHL]) Meningocutaneous Angiomatosis (Encephalotrigeminal Angiomatosis; Sturge–Weber Syndrome [SWS]) Neurofibromatosis (Figs. 2.3–2.5) Tuberous Sclerosis (Bourneville’s Disease; Pringle’s Disease) Other Phakomatoses Chromosomal Aberrations Trisomy 8 Trisomy 13 (47,13+; Patau’s Syndrome) Trisomy 18 (47,18+; Edwards’ Syndrome) Trisomy 21 (47,21+; Down’s Syndrome) Triploidy Chromosome 4 Deletion Defect Chromosome 5 Deletion Defect (46,5p−; Cri du Chat Syndrome) Chromosome 11 Deletion Defect Chromosome 13 Deletion Defect Chromosome 17 Deletion (17p11.2; Smith–Magenis Syndrome) Chromosome 18 Deletion Defect (46,18p−; 46,18q−; or 46,18r; Partial 18 Monosomy) (Fig. 2.11) Chromosome 47 Deletion Defect Mosaicism Infectious Embryopathy Congenital Rubella Syndrome (Gregg’s Syndrome) Cytomegalic Inclusion Disease Congenital Syphilis Toxoplasmosis Drug Embryopathy Fetal Alcohol Syndrome (FAS) (Fig. 2.15) Thalidomide Lysergic Acid Diethylamide (LSD) (Fig. 2.16) Other Congenital Anomalies Cyclopia and Synophthalmos Anencephaly Anophthalmos (Fig. 2.18) Microphthalmos Noonan Syndrome (NS) Walker–Warburg Syndrome Oculocerebrorenal Syndrome of Miller Subacute Necrotizing Encephalomyelopathy (Leigh’s Disease) Meckel’s Syndrome (Dysencephalia Splanchnocystica; Gruber’s Syndrome) Potter’s Syndrome Menkes’ Kinky-Hair Disease Aicardi’s Syndrome Ectrodactyly–Ectodermal Dysplasia (EEC) Trichothiodystrophy (TD) Dwarfism Other Syndromes Bibliography Angiomatosis Retinae Meningocutaneous Angiomatosis Neurofibromatosis Tuberous Sclerosis Other Phakomatoses Chromosomal Trisomy Defects Triploidy and Chromosomal Deletion Abnormalities Mosaicism Infectious Embryopathy Drug Embryopathy Other Congenital Anomalies 3 Nongranulomatous Inflammation Definition Classification Terminology Sources of Inflammation Suppurative Endophthalmitis and Panophthalmitis Clinical Features Classification Histology Examples Nonsuppurative, Chronic Nongranulomatous Uveitis and Endophthalmitis Clinical Features Classification Examples Sequelae of Uveitis, Endophthalmitis, and Panophthalmitis Cornea Anterior Chamber Iris Lens Ciliary Body Vitreous Compartment Choroid Retina Glaucoma End Stage of Diffuse Ocular Diseases Bibliography Suppurative Endophthalmitis and Panophthalmitis Nonsuppurative, Chronic Nongranulomatous Uveitis and Endophthalmitis Sequelae of Uveitis, Endophthalmitis, and Panophthalmitis 4 Granulomatous Inflammation Introduction Post-Traumatic Sympathetic Uveitis (Sympathetic Ophthalmia [SO], Sympathetic Ophthalmitis) Phacoanaphylactic (Phacoimmune, Phacoantigenic, or Phacogenic) Endophthalmitis Foreign-Body Granulomas Nontraumatic Infections Viral Bacterial Fungal Parasitic Nontraumatic Noninfectious Sarcoidosis (Figs. 4.22–4.27) Granulomatous Scleritis Chalazion Xanthogranulomas (Juvenile Xanthogranuloma and Langerhans’ Granulomatoses; Histiocytosis X) Granulomatous Reaction to Descemet’s Membrane Chédiak–Higashi Syndrome Allergic Granulomatosis and Midline Lethal Granuloma Syndrome Weber–Christian Disease (Relapsing Febrile Nodular Nonsuppurative Panniculitis) Vogt–Koyanagi–Harada Syndrome (Uveomeningoencephalitic Syndrome) Familial Chronic Granulomatous Disease of Childhood Bibliography Sympathetic Uveitis Phacoanaphylactic Endophthalmitis Foreign-Body Granulomas Viral Bacterial Fungal Parasitic Sarcoidosis Granulomatous Scleritis Granulomatous Reaction to Descemet’s Membrane Vogt–Koyanagi–Harada Syndrome Familial Chronic Granulomatous Disease of Childhood 5 Surgical and Nonsurgical Trauma Causes of Enucleation Complications of Intraocular Surgery Adult Cataract Surgery Immediate Postoperative Congenital Cataract Surgery Delayed Complications of Neural Retinal Detachment and Vitreous Surgery Including Intravitreal Injections Intravitreal Injections Incisional Vitreoretinal Surgery Neural Retinal Detachment Immediate Postoperative Delayed Vitreous Surgery Complications of Corneal Surgery Endothelial Transplant Procedures Introduction Penetrating Keratoplasty (Graft) Other Refractive Keratoplasties Complications of Glaucoma Surgery Complications of Nonsurgical Trauma Introduction Contusion Penetrating and Perforating Injuries Intraocular Foreign Bodies Chemical Injuries Burns Ocular Effects of Injuries to Other Parts of the Body Radiation Injuries (Electromagnetic) Bibliography Causes of Enucleation Complications of Intraocular Surgery Complications of Retinal Detachment and Vitreous Surgery Including Intraocular Injections Complications of Corneal Surgery Complications of Glaucoma Surgery Complications of Nonsurgical Trauma 6 Skin and Lacrimal Drainage System Skin Normal Anatomy (Figs. 6.1 and 6.2) Epidermis Dermis Subcutaneous Tissue Terminology Orthokeratosis and Parakeratosis Acanthosis Dyskeratosis Acantholysis Bulla Atrophy Atypical Cell Leukoplakia Polarity Congenital Abnormalities Dermoid and Epidermoid Cysts Phakomatous Choristoma Miscellaneous Choristomas and Hamartomas Cryptophthalmos (Ablepharon) Microblepharon Coloboma Epicanthus Ectopic Caruncle Lid Margin Anomalies Eyelash Anomalies Ptosis Ichthyosis Congenita Xeroderma Pigmentosum Aging Atrophy Senile Ectropion and Entropion Dermatochalasis and Blepharochalasis Herniation of Orbital Fat Floppy Eyelid Syndrome Inflammation Terminology Viral Diseases Bacterial Diseases Fungal and Parasitic Diseases Lid Manifestations of Systemic Dermatoses or Disease Ichthyosis Congenita Xeroderma Pigmentosum Pemphigus Ehlers–Danlos Syndrome (“India-Rubber Man”) Cutis Laxa Pseudoxanthoma Elasticum Erythema Multiforme Epidermolysis Bullosa Contact Dermatitis Collagen Diseases Granulomatous Vasculitis Vasculitis-Like Disorders and Leukemia/Lymphoma Xanthelasma Necrobiotic Xanthogranuloma Juvenile Xanthogranuloma (JXG) Amyloidosis Atrophic Papulosis (Köhlmeier–Degos Disease) (Benign and Malignant) Calcinosis Cutis Lipoid Proteinosis (Urbach–Wiethe Disease, Hyalinosis Cutis et Mucosae) Idiopathic Hemochromatosis Relapsing Febrile Nodular Nonsuppurative Panniculitis (Weber–Christian Disease) Pigmentation Cysts, Pseudoneoplasms, and Neoplasms Benign Cystic Lesions Benign Tumors of the Surface Epithelium Precancerous Tumors of the Surface Epithelium Cancerous Tumors of the Surface Epithelium Tumors of the Epidermal Appendages (Adnexal Skin Structures) Merkel Cell Carcinoma (Neuroendocrine Carcinoma, Trabecular Carcinoma) (Fig. 6.45) Malacoplakia Pigmented Tumors Mesenchymal Tumors Metastatic Tumors Lacrimal Drainage System Normal Anatomy (Fig. 6.46) Congenital Abnormalities Atresia of the Nasolacrimal Duct Atresia of the Punctum Congenital Fistula of Lacrimal Sac (Minimal Facial Fissure) Inflammation—Dacryocystitis (Fig. 6.47) Blockage of Tear Flow Into the Nose Tumors Epithelial Melanotic Mesenchymal Miscellaneous Bibliography Congenital Abnormalities Aging Inflammation Lid Manifestations of Systemic Dermatoses or Disease Cysts, Pseudoneoplasms, and Neoplasms Lacrimal Drainage System Tumors 7 Conjunctiva Normal Anatomy Congenital Anomalies Cryptophthalmos (Ablepharon) Epitarsus Hereditary Hemorrhagic Telangiectasia (Rendu–Osler–Weber Disease) Ataxia–Telangiectasia (Louis–Bar Syndrome) Congenital Conjunctival Lymphedema (Milroy’s Disease, Nonne–Milroy–Meige Disease) Miscellaneous Dermoids, Epidermoids, and Dermolipomas Choristomas Laryngo-Onycho-Cutaneous (LOC or Shabbir) Syndrome Vascular Disorders Sickle-Cell Anemia Conjunctival Hemorrhage (Subconjunctival Hemorrhage) Lymphangiectasia Lymphangiectasia Hemorrhagica Conjunctivae Ataxia–Telangiectasia Diabetes Mellitus Hemangioma and Lymphangioma Inflammation Basic Histologic Changes Specific Inflammations Infectious Noninfectious Injuries Conjunctival Manifestations of Systemic Disease Deposition of Metabolic Products Deposition of Drug Derivatives Vitamin A Deficiency: Bitot’s Spot Sjögren’s Syndrome Skin Diseases Degenerations Xerosis Pterygium Pinguecula Lipid Deposits Amyloidosis Conjunctivochalasis Cysts, Pseudoneoplasms, and Neoplasms Choristomas Hamartomas Cysts Pseudocancerous Lesions Potentially Precancerous Epithelial Lesions Cancerous Epithelial Lesions Pigmented Lesions of the Conjunctiva Stromal Neoplasms Bibliography Normal Anatomy Congenital Anomalies Vascular Disorders Inflammation Conjunctival Manifestations of Systemic Diseases Degenerations Cysts, Pseudoneoplasms, and Neoplasms 8 Cornea and Sclera Cornea Normal Anatomy Congenital Defects Absence of Cornea Abnormalities of Size Aberrations of Curvature Congenital Corneal Opacities Clinicopathologic Types—General Clinicopathologic Types—Specific Inflammations—Nonulcerative Epithelial Erosions and Keratitis Subepithelial Keratitis Superior Limbic Keratoconjunctivitis Stromal (Interstitial) Keratitis Endothelial Inflammations—Ulcerative Peripheral Central Inflammations—Corneal Sequelae Injuries Degenerations Epithelial Stromal Endothelial Dystrophies and Simulating Disorders Introduction Classification of Dystrophies True Corneal Dystrophies (Table 8.5) Primary in the Corneal Pigmentations (Table 8.14) Melanin Blood Iron Lines Kayser–Fleischer Ring Tattoo Drug-Induced Infections Crystals Neoplasm Sclera Congenital Anomalies Blue Sclera Ochronosis (Alkaptonuria) Inflammations Episcleritis Scleritis (Fig. 8.71) Introduction Tumors Fibromas Nodular Fasciitis Hemangiomas Neurofibromas Contiguous Tumors Conjunctival Tumors Episcleral Osseous Choristoma and Episcleral Osseocartilaginous Choristoma Ectopic Lacrimal Gland Bibliography Normal Anatomy Congenital Defects Inflammations: Nonulcerative Inflammations: Ulcerative Degenerations: Epithelial Degenerations: Stromal Dystrophies: Introduction and Classification Dystrophies: Epithelial-Stromal Including TGFB1 Corneal Dystrophies Dystrophies: Stromal Dystrophies: Descemet’s Membrane and Endothelial Heredofamilial Nonheredofamial Dystrophy-Like Syndromes Crystals Congenital Anomalies Inflammations 9 Uvea Normal Anatomy Congenital and Developmental Defects Persistent Pupillary Membrane (PPM) Persistent Tunica Vasculosa Lentis Heterochromia Iridis and Iridum Hematopoiesis Ectopic Intraocular Lacrimal Gland Tissue Congenital and Developmental Defects of the Pigment Epithelium Aniridia (Hypoplasia) of the Iris Ectropion Uveae (Hyperplasia of Iris Pigment Border or Seam) Peripheral Dysgenesis of the Cornea and Iris Coloboma Cysts of the Iris and Anterior Ciliary Body (Pars Plicata) Cysts of the Posterior Ciliary Body (Pars Plana) Inflammations Injuries Systemic Diseases Diabetes Mellitus Vascular Diseases Cystinosis Homocystinuria Amyloidosis Juvenile Xanthogranuloma (Nevoxanthoendothelioma) Langerhans’ Granulomatoses (Histiocytosis X) Collagen Diseases Mucopolysaccharidoses Atrophies and Degenerations Iris Neovascularization (Rubeosis Iridis) Choroidal Folds Heterochromia Macular Degeneration Dystrophies Iris Nevus Syndrome Chandler’s Syndrome Essential Iris Atrophy Iridoschisis Choroidal Dystrophies Tumors Epithelial Muscular Vascular Osseous Melanomatous Leukemic and Lymphomatous (See Chapter 14) Other Tumors Secondary Neoplasms Uveal Edema (Uveal Detachment; Uveal Hydrops) Types Bibliography Normal Anatomy Congenital and Developmental Defects Systemic Diseases Atrophies and Degenerations Dystrophies Tumors Uveal Edema 10 Lens Normal Anatomy General Information Congenital Anomalies Introduction Mittendorf’s Dot Congenital Aphakia Congenital Duplication of Lens Fleck Cataract Anterior Polar Cataract Posterior Polar Cataract Anterior Lenticonus (Lentiglobus) Posterior Lenticonus (Lentiglobus) Other Congenital Cataracts Capsule (Epithelial Basement Membrane) General Reactions Exfoliation of the Lens Capsule Pseudoexfoliation Syndrome (Pseudoexfoliation of Lens Capsule, Exfoliation Syndrome, Basement Membrane Exfoliation Syndrome, Fibrillopathia Epitheliocapsularis) (Figs. 10.8–10.11) Epithelium Proliferation and Migration of Epithelium Anterior Subcapsular Cataract (ASC) (Figs. 10.12–10.15) Posterior Subcapsular Cataract (PSC) (Figs. 10.16 and 10.17; see Fig. 10.15) Elschnig’s Pearls (see Fig. 5.15) Degeneration and Atrophy of the Epithelium Cortex and Nucleus (Lens Cells or “Fibers”) Cortex (“Soft Cataract”) Nucleus (“Hard Cataract”) Age-Related (Senile) Cataracts Secondary Cataracts Intraocular Disease Trauma Toxic Endocrine, Metabolic, and Others Complications of Cataracts Glaucoma Phacoanaphylactic Endophthalmitis Ectopic Lens Congenital Bibliography Normal Anatomy General Information Congenital Anomalies Capsule Epithelium Cortex and Nucleus Secondary Cataracts Complications of Cataracts Ectopic Lens 11 Neural (Sensory) Retina Normal Anatomy Congenital Anomalies Albinism (Fig. 11.4) Grouped Pigmentation (Bear Tracks) Coloboma Retinal Dysplasia Lange’s Fold Congenital Nonattachment of the Retina Neural Retinal Cysts Myelinated (Medullated) Nerve Fibers Oguchi’s Disease Foveomacular Abnormalities Leber’s Congenital Amaurosis Inherited Retinal Arteriolar Tortuosity Vascular Diseases Definitions Retinal Ischemia Causes Complications of Retinal Ischemia Histology of Retinal Ischemia Retinal Hemorrhagic Infarction (Fig. 11.12) Causes and Risk Factors of Hemorrhagic Infarction Types of Hemorrhagic Infarction Complications of Hemorrhagic Infarction Histology of Retinal Hemorrhagic Infarction (see Fig. 11.12) Hypertensive and Arteriolosclerotic Retinopathy Hemorrhagic Retinopathy Exudative Retinopathy Diabetes Mellitus Coats’ Disease, Leber’s Miliary Aneurysms, and Retinal Telangiectasia Idiopathic Macular Telangiectasia (Idiopathic Juxtafoveolar Retinal Telangiectasis) Retinal Arterial and Arteriolar Macroaneurysms Sickle-Cell Disease Eales’ Disease (Primary Perivasculitis of the Retina) Retinopathy of Prematurity Hemangioma of the Retina Hereditary Hemorrhagic Telangiectasia (Rendu–Osler–Weber Disease) Disseminated Intravascular Coagulation Inflammations Nonspecific Retinal Inflammations Specific Retinal Inflammations (see Chapters 2–4) Injuries Degenerations Definitions Microcystoid Degeneration Degenerative Retinoschisis Secondary Microcystoid Degeneration and Retinoschisis Paving Stone (Cobblestone) Degeneration (Peripheral Chorioretinal Atrophy; Equatorial Choroiditis) Peripheral Retinal Albinotic Spots Myopic Retinopathy Macular Degeneration Idiopathic Serous Detachment of the RPE (Fig. 11.25) Idiopathic Central Serous Choroidopathy (Central Serous Retinopathy; Central Angiospastic Retinopathy) (see Fig. 11.25) Drusen Dry Age-Related Macular Degeneration (Dry, Atrophic, or Senile Atrophic Macular Degeneration) Age-Related Exudative Macular Degeneration (Exudative, Wet, or Senile Disciform Macular Degeneration; Kuhnt–Junius Macular Degeneration) Congenital Hypotrichosis With Juvenile Macular Degeneration (CHWJMD) Exudative Macular Degeneration Secondary to Focal Choroiditis (Juvenile Disciform Degeneration of the Macula) Idiopathic Polypoidal Choroidal Vasculopathy Cystoid Macular Edema (Irvine–Gass Syndrome) Toxic Retinal Degenerations Postirradiation Retinopathy Bone Marrow Transplant Retinopathy Cancer-Associated Retinopathy (Paraneoplastic Syndrome; Paraneoplastic Retinopathy; Paraneoplastic Photoreceptor Retinopathy; Melanoma-Associated Retinopathy) Idiopathic Macular Holes Light Energy Retinopathy Traumatic Retinopathy Hereditary Primary Retinal Dystrophies Definitions X-Linked Retinoschisis (Juvenile Retinoschisis, Vitreous Veils; Congenital Vascular Veils; Cystic Disease of the Retina; Congenital Retinal Detachment) Choroidal Dystrophies Stargardt’s Disease (Fundus Flavimaculatus) Dominant Drusen of Bruch’s Membrane (Doyne’s Honeycomb Dystrophy; Malattia Lèventinese; Hutchinson–Tay Choroiditis; Guttate Choroiditis; Holthouse–Batten Superficial Choroiditis; Family Choroiditis; Crystalline Retinal Degeneration; Iridescent Crystals of the Macula; Hyaline Dystrophies) Best Vitelliform Disease (Vitelliform Foveal Dystrophy; Vitelliform Macular Degeneration; Vitelliruptive Macular Degeneration; Exudative Central Detachment of the Retina—Macular Pseudocysts; Cystic Macular Degeneration; Exudative Foveal Dystrophy) Dominant Progressive Foveal Dystrophy Dominant Cystoid Macular Dystrophy (DCMD) Fenestrated Sheen Macular Dystrophy North Carolina Macular Dystrophy Familial Internal Limiting Membrane Dystrophy Central Pigmentary Sheen Dystrophy Cone–Rod Dystrophy Annular Macular Dystrophy (Benign Concentric Annular Macular Dystrophy) Retinitis Punctata Albescens (Albipunctate Dystrophy; Fundus Albipunctatus; Panretinal Degeneration) Central Retinitis Pigmentosa (Central Retinopathia Pigmentosa; Retinopathia Pigmentosa Inversa; Retinitis Pigmentosa Inversa; Pericentral Pigmentary Retinopathy) Retinitis Pigmentosa (Retinopathia Pigmentosa; Pigmentary Degeneration of the Retina) Clumped Pigmentary Retinal Dystrophy (Clumped Pigmentary Retinal Degeneration) Hereditary Pigmented Paravenous Chorioretinal Atrophy Pigment Epithelial Dystrophy Central Areolar Pigment Epithelial Dystrophy Patterned Dystrophies of the Retinal Pigment Epithelium (Reticular Dystrophy or Sjögren Dystrophia Reticularis Laminae Pigmentosae Retinae; Butterfly-Shaped Pigment Dystrophy of the Fovea; Macroreticular or Spider Dystrophy) Bietti’s Crystalline Dystrophy (Bietti’s Tapetoretinal Degeneration With Marginal Corneal Dystrophy, Crystalline Retinopathy) Sorsby Fundus Dystrophy (Sorsby’s Pseudoinflammatory Macular Dystrophy; Hereditary Macular Dystrophy) Autosomal-Dominant Occult Macular Dystrophy Unilateral Retinal Pigment Epithelial Dysgenesis (URPED) Recessive Retinopathy Consequent on Mutant G-Protein β Subunit 3 (GNB3) Martinique Crinkled Retinal Pigment Epitheliopathy (MCRPE) Hereditary Secondary Retinal Dystrophies Angioid Streaks Sjögren–Larsson Syndrome (S-LS) Mucopolysaccharidoses Mucolipidoses Sphingolipidoses Other Lipidoses Disorders of Carbohydrate Metabolism Primary Hyperoxaluria (Primary Oxalosis; Fig. 11.43) Osteopetrosis Homocystinuria Systemic Diseases Involving the Retina Hereditary Secondary Retinal Dystrophies Diabetes Mellitus Hypertension and Arteriolosclerosis Collagen Diseases Blood Dyscrasias Demyelinating Diseases Tumors Glia Phakomatoses Retinal Pigment Epithelium Retinoblastoma and Pseudogliomas Neural Retinal Metastases (Fig. 11.49) Neural Retinal Detachment Definitions Major Causes Classification of Neural Retinal Detachment Predisposing Factors to Neural Retinal Detachment Pathologic Changes After Neural Retinal Detachment Pathologic Complications After Neural Retinal Detachment Surgery Bibliography Normal Anatomy Congenital Anomalies Vascular Disease Inflammation Degenerations Hereditary Primary Retinal Dystrophies Hereditary Secondary Retinal Dystrophies Systemic Diseases Involving the Retina Tumors Retinal Detachment 12 Vitreous Normal Anatomy Congenital Anomalies Persistent Primary Vitreous Persistent Fetal Vasculature (PFV; Persistent Hyperplastic Primary Vitreous [PHPV]) Inflammation Acute Chronic Vitreous Adhesions Post Nonsurgical and Surgical Trauma Postinflammation Idiopathic Vitreous Opacities Hyaloid Vessel Remnants Acquired Vitreous Strands and Floaters Inflammatory Cells Red Blood Cells Iridescent Particles Tumor Cells Pigment Dust Cysts Retinal Fragments Traumatic Avulsion of Vitreous Base Vitreous Detachment Proteinaceous Deposits Amyloid Familial Exudative Vitreoretinopathy (FEVR) Autosomal-Dominant Vitreoretinochoroidopathy (ADVIRC; Peripheral Annular Pigmentary Dystrophy of the Retina) Autosomal-Dominant Neovascular Inflammatory Vitreoretinopathy (ADNIV) Erosive Vitreoretinopathy Knobloch Syndrome Vitreous Hemorrhage Definitions Causes Complications Bibliography Normal Anatomy Congenital Anomalies Vitreous Adhesions Vitreous Opacities Vitreous Hemorrhage 13 Optic Nerve Normal Anatomy Congenital Defects and Anatomic Variations Aplasia Hypoplasia Dysplasia Anomalous Shape of Optic Disc and Cup Congenital Crescent or Conus Congenital (Familial) Optic Atrophies Coloboma (Table 13.1) Myopia Optic Disc Edema General Information (Fig. 13.7; see Fig. 13.22) Causes Pseudopapilledema Histology of Optic Disc Edema Optic Neuritis Causes Histology of Optic Neuritis Optic Atrophy Causes Histology of Optic Atrophy Injuries Tumors Primary Secondary Bibliography Normal Anatomy Congenital Defects and Anatomic Variations Optic Disc Edema Optic Neuritis Optic Atrophy Tumors 14 Orbit Normal Anatomy Exophthalmos Developmental Abnormalities Developmental Abnormalities of Bony Orbit Microphthalmos With Cyst Cephaloceles Congenital Alacrima Orbital Inflammation Acute Chronic Injuries Penetrating Wounds Nonpenetrating Wounds Vascular Disease Primary Part of Systemic Disease Ocular Muscle Involvement in Systemic Disease Graves’ Disease (Fig. 14.10) Myasthenia Gravis (MG) Myotonic Dystrophy (Myotonia Dystrophica; Steinert’s Disease) Myotonia Congenita (Thomsen’s Disease) Mitochondrial Myopathies Dermatomyositis Neoplasms and Other Tumors Primary Orbital Tumors Secondary Orbital Tumors Bibliography Normal Anatomy Exophthalmos Developmental Abnormalities Orbital Inflammation Injuries Vascular Disease Ocular Muscle Involvement in Systemic Disease Tumors: Choristoma Tumors: Hamartomas Tumors: Mesenchymal–Vascular Tumors: Mesenchymal–Fatty Tumors: Mesenchymal–Fibrous–Histiocytic Tumors: Mesenchymal–Muscle Tumors: Mesenchymal–Cartilage Tumors: Mesenchymal–Bone Tumors: Neural Tumors: Miscellaneous Tumors: Epithelial of Lacrimal Gland Tumors: Reticuloendothelial System Tumors: Inflammatory Pseudotumor Tumors: Malignant Lymphoma Tumors Leukemia Tumors: Monoclonal and Polyclonal Gammopathies Secondary Tumors 15 Diabetes Mellitus Natural History Ocular Surface Disease Intraocular Changes Lens Iris Ciliary Body and Choroid Retinal Vasculature in Normal Subjects and Diabetic Patients Neural Retina Vitreous Optic Nerve Bibliography Natural History Ocular Surface Disease Lens Ciliary Body and Choroid Retina Vitreous Optic Nerve 16 Glaucoma Normal Anatomy (Figs. 16.1–16.3) Introduction Normal Outflow Hypersecretion Impaired Outflow Congenital Glaucoma (Table 16.3) Primary Glaucoma (Closed- and Open-Angle) Secondary Angle-Closure Glaucoma Causes Secondary Open-Angle Glaucoma Tissue Changes Caused by Elevated Intraocular Pressure Cornea (Figs. 16.26–16.28; See Also Fig. 8.49A,B) Anterior-Chamber Angle Iris Ciliary Body Lens Sclera Neural Retina (Fig. 16.31) Optic Nerve Bibliography Normal Anatomy Introduction Impaired Outflow: Congenital Glaucoma Impaired Outflow: Primary Closed-Angle Impaired Outflow: Primary Open-Angle Impaired Outflow: Secondary Closed-Angle Impaired Outflow-Secondary Open-Angle Tissue Changes Caused by Elevated Intraocular Pressure 17 Ocular Melanocytic Tumors Normal Anatomy Ocular Melanocytes Melanotic Tumors of Eyelids Ephelis (Freckle) Lentigo Nevus Malignant Melanoma Melanotic Tumors of Conjunctiva Ephelis (Freckle) Lentigo Nevus Primary Acquired Melanosis (PAM; Figs. 17.15 and 17.16; see also Table 17.2) Primary Malignant Melanoma of Conjunctiva (Fig. 17.17; see also Fig. 17.16) Lesions That May Simulate Primary Conjunctival Nevus or Malignant Melanoma Melanotic Tumors of Pigment Epithelium of Iris, Ciliary Body, and Retina Reactive Tumors Nonreactive Tumors Acquired Neoplasms Melanotic Tumors of the Uvea Iris Ciliary Body and Choroid Melanotic Tumors of the Optic Disc and Optic Nerve Melanocytoma (Magnocellular Nevus of the Nerve Head) Malignant Melanoma Melanotic Tumors of the Orbit Bibliography Melanocytic Tumors of the Eyelids Melanocytic Tumors of Conjunctiva Melanocytic Tumors of Pigment Epithelium of Iris, Ciliary Body, and Retina Melanocytic Tumors of the Uvea: Iris Melanocytic Tumors of the Uvea: Ciliary Body and Choroid Melanocytic Tumors of the Orbit 18 Retinoblastoma and Simulating Lesions Retinoblastoma General Information Heredity Clinical Features Histology Prognosis Overview Lesions Simulating Retinoblastoma (Pseudoglioma) General Information Leukokoria (Box 18.1) Discrete Retinal or Chorioretinal Lesions Bibliography Retinoblastoma—General Information Retinoblastoma—Heredity Retinoblastoma—Clinical Features Retinoblastoma—Histology Retinoblastoma—Prognosis Lesions Simulating Retinoblastoma (Pseudoglioma)—General Information Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Introduction Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Persistent Fetal Vasculature Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Retinal Dysplasia Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Retinopathy of Prematurity Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Coats’ Disease Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Incontinentia Pigmenti Lesions Simulating Retinoblastoma (Pseudoglioma)—Leukokoria: Other Causes Index A B C D E F G H I J K L M N O P R S T U V W X Z **Bridge the gap between ophthalmology and pathology** with the 8th Edition of this comprehensive, easy-to-understand reference from Drs. Myron Yanoff and Joseph W. Sassani. Designed to keep you up to date with every aspect of the field, from current imaging techniques to genetics and molecular biology to clinical pearls, __Ocular Pathology__ provides **the concise yet complete information you need** for board exams and clinical practice.