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Ophthalmic Pathology
Sunday, March 18, 2012, 7:30 PM
Convention Centre 215
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Pathology of the Cornea
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Moderator:
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THOMAS J. CUMMINGS
Duke Univ Med Ctr
Durham, NC
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Disclosure:
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In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose.
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Panelists:
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Michele M. Bloomer, UCSF , San Francisco, CA
Patricia Chevez-Barrios, The Methodist Hospital, Houston, TX
Gordon K. Klintworth, Duke Univ Medical Center, Durham, NC
Lynn Schoenfield, Cleveland Clinic, Cleveland, OH
Nora V. Laver, Tufts Medical Centr, Boston, MA
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Clinical histories are displayed below.
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Submitted by: Michele M. Bloomer -
UCSF , San Francisco, CA
A 31 year old female with a history of congenital cataracts and microphthalmos underwent cataract surgery and was left aphakic. Over the next few years the patient’s vision deteriorated and she developed pain. The patient also has a history of glaucoma controlled by topical drops. Best corrected visual acuity at presentation was 20/200. Her cornea was opaque with a central corneal thickness of 904µm. She had several corneal epithelial defects. A penetrating keratoplasty was performed and the cornea button was sent to pathology.
Submitted by: Patricia Chevez-Barrios -
The Methodist Hospital, Houston, TX
The patient is a 56 year-old female with history of slowly decrease in visual acuity for several years with a sister that had similar symptomas and necessitated a corneal graft. Visual acuity in both eyes was 20/200. On slit lamp examination the cornea shows bilateral central white deposits in the stroma that are granular with clear spaces in between. No epithelial defects or endothelial lesions were seen. The patient also had 1+ subcapsular lens opacities. The remainder of the ocular examination was within normal limits. She underwent keratectomy (corneal graft) of the left eye.
Case 2 - Figure 1
Clinical picture of cornea with well-defined deposits in the stroma with clear spaces. |
Case 2 - Figure 2
H&E stain of keratectomy specimen with eosinophilic deposits in stroma and Bowman's layer. |
Case 2 - Figure 3
Trichrome Masson stain of keratectomy specimen showing bright red deposits in stroma and Bowman's layer. |
Submitted by: Gordon K. Klintworth -
Duke Univ Medical Center, Durham, NC
A 55 year old Caucasian woman presented with progressive clouding of her vision over an eight year period. None of her family were known to have any eye disease. Bilateral corneal opacities were centered over the visual axis. Her vision could not be corrected by refraction and to restore vision a penetrating keratoplasty was performed.
Submitted by: Lynn Schoenfield -
Cleveland Clinic, Cleveland, OH
Case 4a: 49 year old male with presumed fungal endophthalmitis.
Case 4b: 82 year old female with corneal melt syndrome.
Case 4c: 74 year old male with HPN and DM with previous corneal transplant and expected
endophthalmitis. He subsequently required enucleation, which revealed endophthalmitis
and necrotizing keratitis.
Case 4d: 79 year old male with perforated ulcer. He subsequently required enucleation.
Case 4e: 59 year old female with keratitis and history of contact lens use.
Case 4f: 80 year old female with chronic corneal ulcer.
Case 4a - Slide 1
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Case 4a - Slide 2
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Case 4b - Slide 1
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Case 4b - Slide 2
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Case 4c - Slide 1
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Case 4c - Slide 2
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Case 4c - Slide 3
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Case 4d - Slide 1
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Case 4d - Slide 2
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Case 4e - Slide 1
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Case 4e - Slide 2
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Case 4f - Slide 1
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Case 4f - Slide 2
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Submitted by: Nora V. Laver -
Tufts Medical Centr, Boston, MA
88-year-old female referred to the eye clinic for a papillomatous growth in the right eye involving the cornea and nasal conjunctiva, progressively increasing in size. The patient denied pain or discomfort, floaters, or change in vision. Her ocular history was significant for central retinal vein occlusion in her right eye ten years ago. She also had glaucoma with suspected narrow angles, no previous surgery or laser treatment. Her medical history was significant for hypertension, pacemaker and hypothyroidism.
Case 5 - Slide 1
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