Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002
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association with diabetes mellitus
5. Traumaâ??from contusions, wounds, or intraocular operations 6. Turks lineâ??fine vertical line in the lower portion of the cornea
2. Hematogenous pigmentation
A.*Blood staining of the cornea, most often because of total hyphema associated with elevated intraocular pressure
B.Hemorrhage into corneaâ??following subconjunctival hemorrhage and intracorneal hemorrhage from newly formed vessels, as in interstitial keratitis or mustard gas keratitis
C.Epithelial deposit associated with spherocytic anemia
D.Hemachromatosis
3. Metallic pigmentation P.249
A.Copper (chalcosis)
1. *Kayserâ??Fleischer ringâ??limbal ring associated with Wilson disease 2. Copper foreign body in cornea or intraocular region
3. Occupational exposure or topical therapeutic use of copper-containing substance 4. Advanced cirrhosis of the liver, such as that associated with parasitic infestation
(schistosomiasis)
B.Silver (argyrosis)â??from topical, local, or systemic use; also occupational use
C.Gold (chrysiasis)â??from topical, local, or systemic use
D.Iron (siderosis)
1. Foreign body in cornea or intraocular area
2. Iron lines
a.Fleischer ringâ??associated with keratoconus around base of the cone
b.Hudsonâ??Stähli lineâ??horizontal line at the junction of the middle and lower one third of the cornea, believed to be related to exposure, trauma of lid closure, and chronic corneal infection
c.Stocker lineâ??line running parallel with head of the pterygium
d.Ferry lineâ??associated with filtering blebs, believed to result from minute, repeated, localized trauma caused by eyelid striking the elevated bleb
e.Circular lesion associated with congenital spherocytosis
f.Iron lines following refractive corneal surgery, such as radial keratotomy and photorefractive keratectomy, and laser in situ keratomileusis (hyperopic and myopic)
E.Bismuth (bismuthiasis)â??from therapeutic use
F.Arsenic melanosis
4. Drugs, discoloration, including the following:
acetophenazine |
calcitriol |
iodide |
acid bismuth sodium |
carphenazine |
iodine solution |
tartrate |
|
|
alcohol |
chloroquine |
iron dextran |
amiodarone |
chlorpromazine |
iron sorbitex |
amodiaquine |
chlorprothixene |
meperidine(?) |
antimony potassium |
chlortetracycline |
mercuric oxide |
tartrate |
|
|
antimony sodium tartrate |
colloidal silver |
mesoridazine |
antimony sodium |
diethazine |
methdilazine |
thioglycolate |
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|
|
echothiophate |
methotrimeprazine |
auranofin |
epinephrine |
methylene blue |
aurothioglucose |
ergocalciferol |
mild silver protein |
aurothioglycanide |
ethopropazine |
perazine |
bismuth carbonate |
ferrocholinate |
perhexiline |
bismuth oxychloride |
ferrous fumarate |
pericyazine |
bismuth salicylate |
ferrous gluconate |
perphenazine |
bismuth sodium tartrate |
ferrous succinate |
phenylmercuric nitrate |
bismuth sodium |
ferrous sulfate |
piperacetazine |
thioglycollate |
|
|
|
fluphenazine |
polysaccharideâ??iron |
|
|
complex |
bismuth sodium |
gold Au 198 |
prazosin |
|
triglycollamate |
gold sodium |
prochlorperazine |
|
|
thiomalate |
|
|
bismuth subcarbonate |
gold sodium |
promazine |
|
|
thiosulfate |
|
|
bismuth subsalicylate |
hydroxychloroquine |
promethazine |
|
butaperazine |
indomethacin |
propiomazine |
|
quinacrine |
stibophen |
trifluoperazine |
|
quinidine |
tetracycline |
triflupromazine |
|
radioactive solution |
thiethylperazine |
trimeprazine |
|
silver nitrate |
thimerosal |
vitamin A(?) |
|
silver protein |
thiopropazate |
vitamin D |
|
sodium |
thioproperazine |
vitamin D2 |
|
antimonylgluconate |
|
|
|
stibocaptate |
thioridazine |
vitamin D3 |
|
stibogluconate |
thiothixene |
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5. Other color changes |
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A.White discolorationâ??scars, fatty degeneration or infiltration, calcified areas
B.Yellow, discolorationâ??hyaline or colloid degeneration, and Tangier disease (familial deficiency of high-density lipoprotein)
C.Black discolorationâ??coal powder, dirt, epinephrine, or ink (tattooing)
D.Yellowâ??brown discolorationâ??Kyrle disease (hyperkeratosis follicularis et parafollicularis in cutem penetrans)
E.Greyâ??black discolorationâ??chronic phenol exposure as carbolic acid
F.Greyâ??white discolorationâ??anesthetic cornea
G.Brown discolorationâ??aniline (amidobenzole), including benzoquinone and hydroquinine
Brodrick JD. Pigmentation of the cornea. Ann Ophthalmol 1979;11:855â??861.Bibliographic
Links
Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.
Krueger R, et al. Corneal iron line associated with steep central islands after photorefractive keratectomy. J Refract Surg 1997;13:401â??403.Bibliographic Links
Lazzaro DR, et al. Corneal findings in hemochromatosis. Arch Ophthalmol 1998;116:1531â??1532.Bibliographic Links
Probst LE. Ocular copper deposition associated with benign monoclonal gammopathy and hypercupremia, keratoconus in identical twins. Cornea 1996;15,1:94â??98.
Probst LE, et al. Pseudo-Fleischer ring after hyperopic laser in situ keratomileusis. J Cataract Refract Surg 1999;25:866â??870.
Corneal Edema
1. Drugs, including the following: |
|
|
acetophenazine |
chlortetracycline |
idoxuridine (IDU) |
acetylcholine |
cocaine |
lanatoside C |
alpha-chymotrypsin |
colistin |
melphalan |
amodiaquine |
deslanoside |
mesoridazine |
amphotericin B |
dibucaine |
methdilazine |
bacitracin |
diethazine |
methicillin |
benoxinate |
digitoxin |
methotrimeprazine |
benzalkonium chloride |
digoxin |
neomycin |
benzathine penicillin G |
dyclonine |
perazine |
butacaine |
epinephrine |
pericyazine |
butaperazine |
erythromycin |
perphenazine |
carbachol |
ethopropazine |
phenacaine |
carphenazine |
fluphenazine |
phenoxymethyl |
|
|
penicillin |
chloramphenicol |
hydrabamine |
phenylephrine |
|
penicillin |
|
chlorhexidine |
hydrogen peroxide |
piperacetazine |
chloroquine |
hydroxychloroquine |
piperocaine |
chlorpromazine |
idoxuridine |
polymyxin B |
potassium penicillin G |
propiomazine |
thiotepa |
potassium penicillin V |
quinacrine |
trifluoperazine |
potassium phenethicillin |
silicone |
triflupromazine |
potassium phenoxymethyl |
streptomycin |
trifluridine |
penicillin |
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tetracaine |
trimeprazine |
procaine penicillin G |
tetracycline |
urokinase |
prochlorperazine |
thiethylperazine |
vidarabine |
promazine |
thiopropazate |
vinblastine |
promethazine |
thioproperazine |
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proparacaine |
thioridazine |
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P.251 |
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2. Endothelial decompensation
A.Noninflammatory
1. *Acute hydrops with keratoconus
2. Congenital
a. Anhidrotic ectodermal dysplasia
b.*Birth trauma, typically a forceps injury
c.Congenital glaucoma
d.Congenital hereditary endothelial dystrophy e. Posterior polymorphous dystrophy
3. Environmental cold in trigeminal nerve palsy
4. Essential corneal edema
5. Failed corneal graft
6. Metabolic such as myxedema and hypercholesteremia
7. Neuropathic conditions
8. Postsurgical
a.Anterior segment ischemia
b.Anterior synechiae
c.Direct mechanical damage to endothelium including argon laser iridotomy
d.Epithelial or fibrous downgrowth
e.Osmotic, such as irrigation of cornea or anterior chamber with distilled water
f.Plasma gas sterilization
g.Stripped Descemet membrane
h.Vitreous touch
9. Primary degenerativeâ??Fuchs dystrophy
10. Traumatic
a.Anoxia of epithelium, such as from excessive wearing of contact lens (Sattler veil)
b.Brownâ??McLean Syndrome
c.Chemical, such as tear gas, hydrogen peroxide and Hibiclens
d.Exposure as in exophthalmos
e.Large epithelial defect
f.Nonpenetrating including after air bag inflation injury
g.Penetrating
h.Radiation injury such as from ultraviolet, roentgenograms, gamma rays
i.Retained foreign body-anterior chamber
j.Sympathectomy including jugular vein catheterization and Parryâ??Robson syndrome
k.Trigeminal nerve palsy with cold exposure
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B.Inflammatory
1. Any severe iritis
2. Acute graft rejection
3. Chandler syndrome (iridocorneal endothelial syndrome)
4. *Herpes simplex keratitis or keratouveitis
5. *Herpes zoster keratouveitis
6. Retinal tacks
3. Increased intraocular pressure
A.*Acute glaucoma
B.Chronic glaucoma
1. Minimal to moderate pressure elevations in the presence of abnormal endothelium 2. Prolonged moderately high elevations in the presence of normal or near-normal
endothelium
4. Hypotony
Duffy RE, et al. An epidemic of corneal destruction caused by plasma gas sterilization. Arch Ophthalmol 2000;118:1167â??1176.Bibliographic Links
Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.
Herse P, Hooker B. Corneal edema recovery dynamics in diabetes: is the alloxan induced diabetic rabbit a useful model? Invest Ophthalmol Vis Sci 1994;35:310â??313.
Lesher MP, et al. Corneal edema, hyphema, and angle recession after air bag inflation. Arch Ophthalmol 1993;111:1320â??1322.Bibliographic Links
Mietz H, et al. Acute corneal necrosis after excimer laser keratectomy for hyperopia. Ophthalmology 1999;106:490â??497.Bibliographic Links
Reed JW, et al. Clinical and pathologic findings of aphakic peripheral corneal edema: Brown-McLean syndrome. Cornea 1992;11:577â??583.Buy NowBibliographic Links
Wilhelmus KR. Corneal edema following argon laser iridotomy. Ophthalmic Surg Lasers 1992;23:533â??537.
Zamir E, et al. Neurotrophic corneal endothelial failure complicating acute Horner syndrome. Ophthalmology 1999;106:1692â??1696.Bibliographic Links
Corneal Hydrops (Ruptures of Descemet Membrane with Cornea Intralamellar Dissection and Collection of Aqueous Humor)
1. Congenital glaucoma
2. Forceps injury
3. *Keratoconus
4. Pellucid marginal degeneration
5. Terrien marginal degeneration
6. Trauma, blunt
Soong HK, et al. Corneal hydrops in Terrien's marginal degeneration. Ophthalmology 1986;93:340â??343.Bibliographic Links
Taglia DP, Sugar J. Case reports and small case series. Arch Opthalmol 1997;115:274â??275.Bibliographic Links
Microcornea (Cornea with a Horizontal Diameter of less than 10 MM)
1. Associated ocular findings
A.Aniridia and subluxated lenses
B.Autosomal-dominant cataract and myopia
P.253
C.Autosomal-dominant cataract, nystagmus, and glaucoma
D.Axenfeld syndrome (posterior embryotoxon)
E.Colobomatous microphthalmia
F.Congenital glaucoma
G.Corectopia and macular hypoplasia
H.Hyperopia
I.Meckel syndrome (dysencephalia splanchnocystica syndrome)
J.Nanophthalmos
K.Narrow-angle glaucoma
L.Sclerocornea
2. Aberfeld syndrome (congenital blepharophimosis associated with generalized myopathy) 3. Autosomal recessive or dominant trait
4. Carpenter syndrome (acrocephalopolysyndactyly II)
5. Cataract microcornea syndrome
6. Chromosome partial deletion (long-arm) syndrome
7. Deafness retardation, arched palate syndrome
8. Ehlersâ??Danlos syndrome (fibrodysplasia elastica generalisata)
9. Gansslen syndrome (familial hemolytic icterus)
10. Hallermannâ??Streiff syndrome (dyscephalic mandibulooculofacial syndrome)
11. Hemifacial microsomia syndrome (Francois Haustrate syndrome)
12. Hutchinsonâ??Gilford syndrome (progeria)
13. Laurenceâ??Moonâ??Biedl syndrome (retinitis pigmentosaâ??polydactylyadiposogenital syndrome)
14. Lenz microphthalmia syndrome
15. Little syndrome (nail patella syndrome)
16. Marchesani syndrome (mesodermal dysmorphodystrophy)
17. Marfan syndrome (arachnodactyly dystrophica mesodermalis congenita)
18. Meckel syndrome (dysencephalia splanchnocystica syndrome)
19. Meyerâ??Schwickerathâ??Weyers syndrome (oculodentodigital dysplasia)
20. Microcornea, glaucoma, absent frontal sinuses
21. Micro syndrome
22. Rieger syndrome (hypodontia and iris dysgenesis)
23. Ring chromosome
24. Roberts pseudothalidomide syndrome
25. Rubella syndrome (Gregg syndrome)
26. Sabinâ??Feldman syndrome
27. Schwartz syndrome (glaucoma associated with retinal detachment)
28. Smithâ??Magenis syndrome
29. Triploidy
30. Trisomy 13 (D trisomy, Patau syndrome)
31. Trisomy syndrome
32. Waardenburg syndrome (interoculoiridodermatoauditive dysplasia)
Mamdal AK, et al. Roberts pseudothalidomide syndrome. Arch Ophthalmol 2000;118:1462â??1465.Bibliographic Links
Mollica F, et al. Autosomal dominant cataract and microcornea associated with myopia in a Sicilian family. Clin Genet 1985;28:42â??46.Bibliographic Links
Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.
Warburg M, et al. Autosomal recessive microcephaly, microcornea, congenital cataract, mental retardation, optic atrophy, and hypogenitalism. Arch Dis Child 1993;147:1309â??1312.
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Diagnostic table
Microcornea
View Table
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Megalocornea (Cornea with a Horizontal Diameter of more than 14 MM)
1. Aarskog syndrome (faciodigitogenital syndrome)
2. Autosomal dominant or recessive trait
3. Congenital glaucoma (rare)
4. Craniosynostosis
5. Down syndrome
6. Facial hemiatrophy
7. Isolated
8. Marchesani syndrome (brachymorphia with spherophakia)
9. Marfan syndrome (arachnodactyly dystrophia mesodermalis congenita)
10. MMR (megalocorneaâ??mental retardation) syndrome
11. MMMM (megalocornea, macrocephaly, mental and motor retardation) syndrome 12. Mucopolysaccharidoses I-S (Scheie syndrome)
13. Neuhauser syndrome (megalocorneaâ??mental retardation syndrome)
14. Oculocerebrorenal syndrome (Lowe syndrome)
15. Oculodental syndrome (Peter syndrome)
16. Osteogenesis imperfecta (van der Hoeve syndrome)
17. Oxycephaly (dysostosis craniofacial dyostosis)
18. Pierre Robin syndrome (micrognathiaâ??glossoptosis syndrome)
19. Posterior embryotoxon
20. Rieger syndrome (hypodontia and iris syndrome)
21. Rubella syndrome (Gregg syndrome)