Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002

3. Scattered opacities

A.Amyloid diseaseâ??rare (seen in older persons)

B.Ankylosing spondylitis

C.Coagula of the colloid basis of the gel

D.Crystalline deposits

1. Asteroid hyalosis

2. Synchysis scintillans

E.Endophthalmitis

F.Heterochromic uveitisâ??in persons 20 to 50 years of age; of all uveitis, iris atrophy, lens changes

G.Myeloma, multipleâ??rare: in persons 50 to 70 years old, associated with bone pain, anemia

H.Myopia, severe

I.Pigment cellsâ??posttraumatic (hemorrhage), senile, or melanotic, associated with rhegmatogenous retinal detachment.

J.Protein coagulaplasmoid vitreous

1. Choroidal tumors (very rareâ??reported in metastatic breast cancer once) 2. Contusions

3. Intermediate uveitis (pars planitis)

4. Retinochoroiditis

K.Red blood cells (see vitreous hemorrhage, p. 424)

L.Snowball opacitiesâ??rare, associated with pars planitis or sarcoidosis, endophthalmitis (indolent)

M.Tissue cellsâ??epithelial, histiocytic, glial

N.Toxoplasmosisâ??active

O.Tumor cellsâ??retinoblastoma in older child, reticulum cell sarcoma (older persons)

P.Vitreous degenerationâ??Wagner disease, Ehlersâ??Danlos syndrome, and Marfan syndrome, senescent aging changes, myopia

Q.Whipple disease

R.White blood cellsâ??inflammatory disease, vitreitis

S.Retinitis pigmentosa

4. Single opacities

A.Anterior hyaloid remnant (Mittendorf dot)â??25% normal eyes, dot on posterior lens surface

B.Hyaloid remnants (uncommon)â??persistent hyperplastic primary vitreous

C.Foreign bodyâ??history of trauma or surgery

D.Dislocated lens (see p. 401)

P.430

E.Parasitic cysts

1. Hydatid disease (echinococcosis)â??rare, children and young adults, tropical

2. Cysticercosisâ??rare

F. Vitreous detachmentâ??common in older or myopic persons

Durant WJ, et al. Vitrectomy and Whipple's disease. Arch Ophthalmol 1984;102:851.

Hong PH, et al. Vitrectomy for large vitreous opacity in retinitis pigmentosa. Am J Ophthalmol 2001;131:133â??134.Bibliographic Links

Recchia AE, et al. Endophthalmitis after pediatric strabismus surgery. Arch Ophthalmol 2000;118:939â??944.Bibliographic Links

Sandgren O, et al. Vitreous amyloidosis associated with homozygosity for the transthyretin methionine gene. Arch Ophthalmol 1990;108:1586.

Persistent Hyperplastic Primary Vitreous

1. Cerebrooculodysplasiaâ??muscular dystrophy

2. Fetal alcohol syndrome

3. Incontinentia pigmenti

4. Norrie disease

5. Septooptic pituitary

6. Sporadic unilateral and isolated finding

7. Trisomy 13

8. Warburg syndrome

Katsuya-Lauer A, et al. Persistent hyperplastic primary vitreous associated with septo-optic-pituitary dysplasia and schizencephaly. Arch Ophthalmol 2000;118:578â??580.Bibliographic Links

Beads in Vitreous (Snowballs in Vitreous)

1. African eye-worm disease (loiasis)

2. Amyloidosis (Lubarschâ??Pick syndrome)

3. Behçet syndrome (dermatostomatoophthalmic syndrome)

4. Birdshot retinochoroidopathy

5. Brucellosis (Bang disease)

6. Familial exudative vitreoretinopathy (Criswickâ??Schepens syndrome)

7. Haemophilus influenzae

8. Irvine syndrome

9. Jacobsenâ??Brodwall syndrome

10. Ocular toxocariasis

C.Cystoid macular edema (CME)

D.Retinal detachment

E.Optic neuritis or papilledema

F.Vitreous hemorrhage

G.Posterior vitreous detachment

Krupin T, Kolker AG. Atlas of complications in ophthalmic surgery. St. Louis: CV Mosby, 1993.

Peyman GA, Shulman JA. Intravitreal surgery: principles and practice. New York: Appleton-Lange, 1994.

Postoperative Vitreous Retraction

Usually, this condition is manifested by circular equatorial retinal fold or star-shaped retinal fold.

1. Accidental perforation of the sclera at operation, which may be associated with hemorrhage and loss of vitreous resulting in a pathologic formation of new epiretinal membrane or proliferative vitreoretinopathy

2. Giant retinal breaks allowing a large area of direct contact between the choroid and the vitreous

3. Perforating diathermy and excessively strong or repeated applications of superficial diathermy, which may cause vitreous hemorrhage or thermal injury to the vitreous; impairment of chorioretinal blood circulation may result in exudation and hemorrhage into the vitreous

4. Venous stasis caused by the compression of vortex veins by the indentation resulting from a buckling procedure

Jaffe NS. The vitreous in clinical ophthalmology. St. Louis: CV Mosby, 1969.

P.432

Vitreous Cyst (Cystic Structure in Vitreous Body)

1. Congenital (developmental)â??may be associated with hyaloid remnants

2. Acquired

A.Infectious cyst

1. Coenurosis (Coenurus cerebralis larva of dog tapeworm) 2. Luetic retinochoroiditis

3. Toxoplasmosis

B.Myopia

C.Parasitic cysts

1. Cysticercosisâ??rare

2. Echinococcosis

3. Hydatid disease (echinococcosis)â??rare, children and young adults, tropical 4. Nematode cyst (toxocariasis)

D.Pigmentary retinopathy

E.Retinal detachment

F.Trauma

Cardillo JA, et al. Post-traumatic proliferative vitreoretinopathy. Ophthalmology 1997;104:1166â??1173.Bibliographic Links

Flynn WJ, Carlson DW. Pigmented vitreous cyst. Arch Ophthal 1994;112:1113.Bibliographic Links

Nussenblat RB, Palestine AG. Uveitis fundamentals and clinical practice. Chicago: Yearbook Medical, 1989.

Vitreous Liquefaction

1. Myopia

2. Peripheral uveitis

3. Retinitis pigmentosa

4. Spontaneous

5. Trauma

6. With aging

7. With vitreous traction such as Wagner disease

Nussenblatt RB, Palestin AG. Uveitis: fundamental and clinical practice. Chicago: Yearbook Medical, 1989.

Takhashi M, et al. Biomicroscopic evaluation and photography of liquefied vitreous in some vitreoretinal disorders. Arch Ophthalmol 1981;99:1555.Bibliographic Links

15

Retina

P.435

Anatomic Classification of Macular Diseases

1. Vitreoretinal surface

A.Preretinal hemorrhage and subinternal limiting membrane hemorrhage

B.Vitreous traction on the macula

C.Epiretinal membrane and macular pucker

2. Nerve fiberâ??ganglion cell layers

A.Hereditary cerebromacular degeneration 1. Sphingolipidoses

a.Tayâ??Sachs disease (GM2â??gangliosidosis type I)

b.Sandhoff disease (GM MDSD2â??gangliosidosis type II)

c.Niemannâ??Pick disease type A (essential lipoid histiocytosis)

d.Niemannâ??Pick disease type B (sea-blue histiocyte syndrome)

e.Lactoside ceramidosis

f.Metachromatic leukodystrophy (arylsulfatase A deficiency)

g.Gaucher disease (glucocerebroside storage disease)

h.Farber lipogranulomatosis

i.Generalized gangliosidosis (GM1â??gangliosidosis type I)

j.Mucolipidosis I (lipomucopolysaccharidosis)

2. Goldberg disease (unclassified syndrome with features of mucopolysaccharidoses, sphingolipidoses, and mucolipidoses)

3. Ceroid lipofuscinosis

a.Hagbergâ??Santevuori (infantile)

b.Janskyâ??Bielschowsky disease (late infantile)

c.Spielmeyerâ??Vogt Batten B. Vitreoretinal dystrophies

1. Macular degeneration in congenital hereditary x-linked retinoschisis

2. Goldmannâ??Favre syndrome (vitreotapetoretinal degeneration)â??recessive

3. Nerve fiber, ganglion cell, inner plexiform, inner nuclear, outer plexiform layers

A.Ischemia secondary to inadequate perfusion of retinal vessels

1. Branch artery occlusion

2. Branch vein occlusion

3. Diabetes mellitus

4. Outer plexiform layer

A.Cystoid macular degeneration (see p. 439) 1. With retinal vascular leakage

a.Acute nongranulomatous iridocyclitis

b.Acute cyclitis

c.Hypertension

d.Medication (epinephrine, nicotinic acid) e. Neoproliferative diabetic retinopathy

P.436

f.Pars planitis

g.Postoperative (Irvineâ??Gass syndrome)

h.Radiation retinopathy

i.Retinitis pigmentosa

j.Sarcoidosis

k.Vascular anomalies

2. Without obvious retinal vascular leakage

a.Vitreous traction on the macula

b.Serous detachment of sensory epithelium

c.Serous detachment of pigment epithelium

d.Hemorrhagic detachment of macula

e.Choroidal tumors

B. Lipid deposits in macula secondary to vascular disease in retina 1. Stellate retinopathy (see p. 443)

a.Hypertensive retinopathy

b.Diabetic retinopathy

c.Coats disease (retinal telangiectasia)

d.Traumaâ??ocular or cerebral

e.Retinal artery or vein occlusion (see p. 457 and 468)

f.Retinal periphlebitis

g.Juxtapapillary choroiditis

h.Papilledema (see p. 593â??601)

i.Angiomatosis retinae

j.Papillitis (see p. 578â??585, 587â??588)

k.Acute, febrile illness, such as measles, influenza, meningitis, erysipelas, psittacosis, Behçet disease

l.Chronic infections, such as tuberculosis or syphilis

m.Coccidioidomycosis

n.Parasitic infection, such as that due to teniae, Giardia, Ancylostoma

o.Idiopathic

2. Circinate retinopathy

a. Senile vascular disease

b.Venous obstruction

c.Diabetic retinopathy

d.Coats disease (retinal telangiectasia)

e.Retinal detachment

f.Anemia

g.Leukemia

h.Idiopathic (primary)

i.Retinal arterial macroaneurysm

3. Diabetic retinopathy

5. Outer nuclear layer or photoreceptor elements

A.Congenital hereditary vision defects

1. Trichromatism (anomalous)

2. Dichromatism

3. Monochromatism

B.Hereditary macular dystrophies

1. Progressive cone dystrophy

2. Inverse (macular) retinitis pigmentosa

P.437

C.Olivopontocerebellar degeneration

D.Light toxicity

1. Operating microscope burn

2. Solar burn

6. Pigment epithelium

A.Hereditary macular dystrophies

1. Vitelliform dystrophy (Best disease)

2. Adult onset foveomacular vitelliform dystrophy (adult Best)

3. Fundus flavimaculatus

4. Fundus flavimaculatus with macular involvement (Stargardt disease)

5. Dominant drusen (Doyne honeycomb dystrophy)

6. Reticular pigment dystrophy (Sjögren)

7. Butterfly-shaped pigment dystrophy (Deutman)

8. Central areolar choroidal and pigment epithelial dystrophy

9. Sorsby fundus dystrophy

B.Inflammatory lesions

1. Rubella syndrome (German measles)

2. Acute posterior multifocal placoid pigment epitheliopathy

C.Toxic lesions

1. Chloroquine

2. Hydroxychloroquine

3. Phenothiazine

a.Chlorpromazine

b. Thioridazine 4. Sparsomycin 5. Ethambutol

6. Indomethacin

7. Quinine

8. Desferrioxamine

9. Penicillamine

D.Drusen (senile, degenerative)

E.Refsum syndrome (phytanic acid storage disease)

F.Myotonic dystrophy syndrome

7. Bruch membrane

A.Angioid streaks associated with

1. Pseudoxanthoma elasticum (Grönbladâ??Strandberg syndrome)

2. Senile elastosis of skin

3. Osteitis deformans (Paget disease)

4. Fibrodysplasia hyperelastica (Ehlerâ??Danlos syndrome)

5. Sickle cell anemia

6. Acromegaly

7. Beta-thalassemia

8. Abetalipoproteinemia (Bassenâ??Kornzweig syndrome)

B.Lacquer cracks in pathologic myopia

C.Traumatic fracture of Bruch membrane

8. Pigment epitheliumâ??Bruch membrane choriocapillaris

A.Degenerative lesions

1. Disciform macular degeneration (senile, juvenile) P.438

2. Age-related macular degeneration

3. Adult hereditary cerebromacular degeneration (Kufs?)

B.Serous detachment of neuroepithelium or pigment epithelium associated with the following:

1. Central serous chorioretinopathy

2. Hemangioma of choroid

3. Malignant melanoma

4. Pit of the optic disk

5. Hypotony (see p. 325â??326)

6. Leukemic infiltrates of choroid

7. Terminal illness

8. Trauma

9. Uveitis

10. Optic neuritis (see p. 578â??585, 587â??588) 11. Papilledema (see p. 593â??601)

12. Acute hypertension